H. I. P. Membership Application Form

 

 

*Name
*Address
*City
*State
*ZIP code
*Phone Number
*Cell Number
*Number of Household Members
*Annual household income
*Select your preferred type(s) of housing: (check all that apply)	Single Family Home (1-3 bedrooms) Single Family Home (4 or more bedrooms) Condominiums Townhomes
*Are you eligible for VA benefits?	Yes No
*e-Mail Address

*your e-mail address is required to submit form

E-mail addresses are public records under Florida law and are not exempt from public-records requirements. If you do not want your e-mail address to be subject to being released pursuant to a public-records request, do not send electronic mail to this entity. Instead, contact this office by telephone (main number is 727-464-8210) or in writing, via the United States Postal Service at 600 Cleveland Street, Suite 800, Clearwater, FL.