Good Neighbor Round Up – Signup Form

Please add the following amount to my KUA utility bill each month, beginning with my next bill: *

Round up to the nearest dollar

$1/month

$2/month

$5/month

First Name *

Last Name *

Email Address (required for confirmation) *

We will confirm your request by phone or email

KUA Service Address *

Country

City

State

Zip code

Phone Number

Comment or Message

*Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.

Captcha *

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For questions about the program including One-time contributions to the fund, please contact KUA’s customer service center at 407-933-9800.

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