Celebrating Tampa Bay's 100+ Year Old Houses and Buildings

A project of the Tampabay Community Design Center (TCDC)

To complete this nomination form you will need to upload a photograph of the house or building. If you encounter issues with this form, contact Julia Gorzka Freeman 813.690.2100
- Full Name
  
  First NameLast Name
- Email Address
  example@example.com
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- I am nominating*
- How long have you owned the house?
- Has it housed more than one generation of your family?
- Please tell us about your home’s history, ownership details, and any fun stories or tidbits. (500‑word max). *Anything you can tell us is helpful to highlight interesting stories on The Century Club Registry and possibly a future coffee table book! *
- Did you attend a Researching Your Home History event at the library?
- How would you like your name(s) to appear on The Century Club Certificate?
- Name of building (optional)
- Current Use & Past Known Uses
- Share your building’s history, ownership details, and any fun stories or tidbits. (500‑word max) *Anything you can tell us is helpful to highlight interesting stories on The Century Club Registry and possibly a future coffee table book! *
- Owner Name(s) – How should your name(s) appear on The Century Club Certificate?
- Name of building
- Is the mailing address the same as the property address?
- Mailing Address
  
  Street Address
  
  CityState Zip Code
- What is your relationship with the building?
- Share the building's history, current and past uses, and any fun stories or tidbits. (500-word max) *Anything you can tell us is helpful to highlight interesting stories on The Century Club Registry and possibly a future coffee table book!
- Is there a separate contact for the building we should notify?
- Name
- Title
- Email
  example@example.com
- Phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Friend/Owner Name(s)
- Owner Email(s)
- Owner Phone(s)
- How long have they owned their house?
- Has it housed more than one generation of their family?
- Please tell us about their home’s history, ownership details, and any fun stories or tidbits. (500‑word max) *Anything you can tell us is helpful to highlight interesting stories on The Century Club Registry and possibly a future coffee table book! *
- How would you like their name(s) to appear on The Century Club Certificate?
- Friend/Owner Name(s)
- Is the mailing address the same as the property address?
- Mailing Address
  
  Street Address
  
  CityState Zip Code
- Has the building served more than one generation of a family business or different owners of the same business?
- Owner Email(s)
- Owner Phone(s)
- Name of building (if applicable)
- Current Use & Past Known Uses
- Share the building's history, ownership details, and any fun stories or tidbits. (500-word max)
- Owner Name(s) - How should their name(s) appear on The Century Club certificate?
- Property Address (required)
  
  Street Address
  
  CityState Zip Code
- Neighborhood?
- What year was it built? (required)
- How was the year determined? (Select all that apply.)
- Please explain (200-word max)
- REQUIRED: Please upload a current photo of the exterior facade and up to 4 additional current and/or historic photos
  
  Preferred formats: JPG or PNG (PDFs also accepted).
  Maximum size: 5MB per file.
  For best clarity: use images at least 1500px wide.
- Cancelof
- Optional: upload up to 5 Document(s) that Shows Date of Construction. Preferred formats PDF or JPG. Maximum size: 5MB per file. For best clarity, use images at least 1500px wide.
  
  Cancelof
- *Nomination Fee is Required.
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  Nomination Fee
  Required fee for submitting a nomination.
  
  $25.00
  
  
  
  Membership (Individual) - Tampabay Community Design Center
  Join Us!
  
  $50.00
  
  
  
  Membership (Dual) - Tampabay Community Design Center
  Membership item
  
  $100.00
  
  
  
  Gift Membership (Individual) - Tampabay Community Design Center
  $50.00
  
  
  
  I would like to make a donation to Tampabay Community Design Center in honor of The Century Club.
  Enter your donation amount for 1 -$25, 2 - $50, 3 - $75, or 4 - $100
  
  $25.00 Quantity
  
  
  
  Total
  
  $0.00
- Please fill out the following fields below for Gift Membership (Individual) - Tampabay Community Design Center.
- Gift Recipient Name
- Gift Recipient Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Gift Recipient Email
  example@example.com
- TAMPABAY COMMUNITY DESIGN CENTER, INC IS A NONPROFIT CORPORATION RECOGNIZED BY THE IRS AS A TAX-EMEPT 501(C)(3) ORGANIZATION. A COPY OF THE OFFICIAL REGISTRATION NUMBER CH57093 AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE 1-800-HELP-FLA (435-7352) or online FDACS.GOV. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.
- REQUIRED
- Payment Methods
  
  Fastlane Checkout
  
  Choose from one of the PayPal options to make your payment.
  
  Contact Info
  
  Payment Info
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A project of the Tampabay Community Design Center (TCDC)

*Nomination Fee is Required.

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