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2. Please fill out the application below in its entirety.
   Be sure to hit SUBMIT at the bottom and provide your email in the field. A copy of your completed application will be sent to the email address provided, and to the Town of Jupiter. Representatives of the Town will follow up on the application and next steps.
4. Neighborhood Information
6. Neighborhood or Community Name:
   Please be specific. For example if your neighborhood is in Abacoa, list the specific Abacoa neighborhood.
8. Are streets and sidewalks publicly accessible?

   1. Yes
   2. No
10. Is the neighborhood platted?

    1. Yes
    2. No
12. Does the neighborhood maintain specialty items within the right-of-way?

    1. Yes
    2. No
14. Has the HOA/POA board taken action to authorize the submittal of this application for inclusion in the Infrastructure Equity Program?

    1. Yes
    2. No
16. Please attach board meeting minutes or other documentation to indicate formal approval to apply to the program.
18. Neighborhood Contact Information
20. First Name
21. Last Name
23. Title
25. Phone Number
26. Contact Email
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field