LGBTQ + Safe Place Initiative Application

Thank you for choosing to participate in our LGBTQ + Safe Place Initiative.  Please complete the form, submit it, and we will be in touch! 

Please Note: Under Florida law (FS 119), e-mail addresses are public records. Do not send electronic mail to this entity if you do not want your e-mail address released in response to a public records request. Instead, contact this office by phone or in writing.