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2. 
3. Pennies For Parks

   The City of Longwood utility customers can opt to enroll in a voluntary round-up/contribution program. Through this program, you can have your utility bill “round up” to the next highest dollar amount, make a monthly contribution, or make a one-time contribution of your choosing. The proceeds from the program will be used to help improve our parks and events.

7. I wish to participate in the round up program. Please automatically round up my utility bill.
9. Account #
10. Name
12. Address
14. City
15. State
16. Zip Code
18. Phone Number
19. Email Address
21. If you prefer to give a specific amount monthly or a flat donation instead of a round up, please fill out one of the lines below. Otherwise, your account information above will be utilized as your approval to “round up” your utility bill to the next dollar.
23. Contribute a monthly amount of your own choosing. Please specify that here:
24. Make a one-time contribution of your own choosing. Please specify that here:
26. THANK YOU SO MUCH FOR YOUR SUPPORT OF THE ROUND UP PROGRAM
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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