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 firstname.lastname@example.org
If you have already completed our former Needs Request Form and are in need of further assistance, please fill out the Existing Member Intake form.
The Center provides limited financial assistance for water and electric bills. All bills must be in “overdue” status. Members must bring a photo ID and proof of residency, e.g., utility bill. Members will only be able to receive financial assistance once every 6 months.