Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Take the Pledge

  1. Stay Distanced, Stay Safe, Stay Open. We can Stop the Spread. Do your part to keep our community saf

  2. The City of Cocoa wants to make sure we keep our community safe and our businesses open. Together, we can stop the spread of the COVID-19 virus. Help us do your part to keep our community safe and healthy.

  3. personal pledge image with icons

  4. As a business patron and citizen in this community we pledge to:

    Staying home when I am sick, Wearing a face covering, Following social distancing and capacity guidelines, Washing and sanitizing my hands before entering, Avoiding physical contact with employees

  5. By submitting this pledge, you are censenting to received emails from the City of Cocoa. You can revoke your consent to receive emails at any time by using the unsubscribe link located at the bottom of every email. Under Florida law, email addresses may constitute a public record. If you do not want your email address released in a public records request, please do not send us electronic mail.

  6. Leave This Blank: