New Member Intake

Navigating through the system of help can be challenging.

Please complete this application in its entirety and we will get back to you within 48 hours. If you have any issues please call us at 727-290-9856 or email us at weempower@empowherment.org

If you have already completed our former Member Intake form and are in need of further assistance, please fill out the Existing Member Intake form.