Information to be considered for possible inclusion in future
Updates of the Housing Resource Directory
 

Program/Project Name: __________________________________________________

Address: ______________________________________________________________

Phone: _________________________________ Fax: _________________________

Contact Person: ________________________________________________________

Attach a brief description of the program or project, including the services offered, the geographical area served, and the client population assisted:

Person completing this form:

Name: _______________________________________________________________

Organization: __________________________________________________________

Address: ______________________________________________________________

Phone: __________________________________ Fax: ________________________

Email: ________________________________________________________________

Is this project funded for a limited time? [ ] Yes [ ] No

If Yes, When do funds expire: (date)

How likely is future funding?

Please mail completed form to :
Housing Resource Directory
Pinellas County Community Development
600 Cleveland Street, Suite 800
Clearwater , FL 33755-4159