FGBC Green Home Advance Registration

FGBC Green Home Advance Registration
Use this form when you need to confirm participation in a green certification program in order to comply with funding or local government permitting requirements OR when you want to order an Application Pending yard sign to place on the project site during construction.

Advance Registration fess are applied to the final application fee when project is submitted for certification.
Project Information
Project Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Development*
County*
Builder Information
Licensed Builder*

First NameLast Name
Builder E-mail*
Phone Number*

Area CodePhone Number
Florida License #*
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Project Contact*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
FGBC Member ID#
FHBA Member ID#
Local HBA Name
Certifying Agent Information
FGBC CA Registration #*
FGBC Certifying Agent*

First NameLast Name
Version*

Application Fees

FGBC & FHBA Member$75.00

Member of FGBC or FHBA$100.00

Non Member of either FGBC or FHBA$125.00

Yard Sign$ Free

Bronze Plaque$39.00

Florida Water Star Certification$40.00

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country