Court-Ordered (PTI/DJJ) or Probation Community Service? If checked, # hours   due by

Name:                                                     Waiver Submitted?

Mailing Address:                                            Phone

City                                                                  Cell 

State     Zip:                                                                     Emergency Contact Name

E-Mail                                                     Emergency Contact Phone

Age/YEAR of birth (Volunteers must be at least 16 years old)

Employer

Employer Address                           Employer Phone
Does your employer have a matching grant program for donations Select Yes No
and/or volunteer hours? Many do; so please ask & help support HFHHC. Thank you!

What days are you available to volunteer?  Select Monday-Friday Saturday

What time of day works best for you? Select Morning Afternoon Evening

What are your interests? (please check all that apply)

Construction / Deconstruction                        Fundraising

Deconstruction Crew Leader                         Recycling

Office                                                            Cleaning

ReStore                                                        Partner to Habitat Family

Provide Lunches                                            Special Events

Media Assistant (website, Ebay, etc.)            Committees (i.e., building, finance, Restore, golf tournament, etc.)

Please indicate your affiliation, if applicable:
Church affiliation

Community Affiliation

School Affiliation

Habitat (are you related in any way to a Habitat homeowner or employee?) Select Yes No
If yes, explain

Please tell us about your skills, talents, experience, or interests:

Yes, I would like to receive the HFHHC newsletter by email

T-Shirt Size (for information only) Select S M L XL XXL

Thank You!
Personal Data Changes
It is important for you to notify the office of any changes in personal data
- mailing address, telephone number, email address, emergency contact name and number -
Please keep these accurate at all times.

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