Street Paving.
© 2012, City of Winter Park

Emergency Utility Assistance Program

Yes, I would like to contribute to the
City of Winter Park Emergency
Utility Assistance Program.

I hereby authorize the City of Winter Park to
add the pledge amount indicated below to my
next monthly bill and continue to do so until
the program is discontinued or until I
notify them in writing that I no longer wish
to participate. I understand that my
contributions are 100 percent tax-deductible.
(NOTE: This donation will appear as a separate line item on your next utility bill.)

If you would like to print and mail the form please download the pdf.
Emergency Utility Assistance Program Form

Name
Address
City
State
ZIP
Account #
Amount


Other