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Pinellas CoC Membership Renewal
Pinellas CoC Membership Renewal (Non-Due Paying)

If any information has changed, please submit a New Member application here:www.pinellascoc.org/join
Name *
Title
First Name
Last Name
Phone *
Email *
Mailing Address *
Address Line 1
City
State
Zip
Organization (if applicable)
Job Title (if applicable)
Website (if applicable)
Check Boxes *

Pinellas CoC members must live, work, or attend school in Pinellas County, or represent organizations that serve Pinellas County. Applicants that do not meet this criteria are ineligible for membership.
Sliding Fee Scale of 100% available for:
Organizations with an annual operating budget under $250,000 or 2 or fewer full-time employees are eligible for 100% off membership dues. Organizations requesting a sliding fee scale are asked to submit a copy of their annual budget and/or organizational chart to confirm eligibility.
Documentation Upload

Upload documentation HERE.
Membership Type (Non-Due Paying) *

More information can be found on membership benefits and levels here: www.pinellascoc.org/join
Conflict of Interest
Agreement *
Questions and Comments

Any questions, comments, or concerns can be emailed to info@hlapinellas.org
To verify you are human, please enter the number 1 *

Homeless Leadership Alliance of Pinellas
647 1st Ave North, St. Petersburg, FL 33701
www.pinellascoc.org
Info@HLAPinellas.org