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2. 
6. First Name*
7. Last Name*
9. Email*
10. Phone*
12. Address1*
14. Address2*
16. City*
17. State*
18. Zip*
22. Are you the property owner or the tenant?*
    -- Select One --Property OwnerTenantBoth
23. Which corridor is the property located on?*
    -- Select One --State Road 7Dixie HighwayFederal HighwayPembroke RoadHollywood BoulevardJohnson StreetTaft StreetSheridan StreetStirling RoadGriffin Street
25. Is the property a privately owned commercial or industrial building?*
    -- Select One --CommercialIndustrial
26. Is the property located within the designated program boundary?*
    -- Select One --YesNo
28. Does the property conform to City of Hollywood's Zoning and Land Development Regulations regarding the use and density permitted?*
    -- Select One --YesNo
29. Does the property have any pending code violations as per City of Hollywood Code Compliance? *
    -- Select One --YesNo
30. How soon would you like to start your project?*
    -- Select One --ImmediatelyNext MonthNext Year
32. Acknowledgement*
    -- Select One --YesNo

    I hereby certify that the above statements are true, correct and complete to the best of my knowledge. I understand that a false statement may disqualify me for the City of Hollywood's Commercial Property Improvement Program.

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