Membership Application

Join our community and help advance neurodiversity initiatives.

First Name *

Last Name *

Email Address *

Phone Number *

Street Address *

Apt/Suite/Building (Optional)

City *

Zip Code *

Chapter Region *

All Florida addresses. This helps us connect you with regional events and members.

Organization (Optional)

Membership Tier *

Briefly describe why you would like to join FLNDCC and how your mission aligns with ours. *

How did you hear about us? (Optional)

You will be redirected to Stripe Checkout to complete your payment. Your membership will be activated immediately upon payment.

30-day refund policy applies. If you're not satisfied, contact us for a full refund within 30 days of joining.