Individual Volunteer Application

First Name Last Name
Mailing Address
City State Zip
Phone () - Cell () -
Email
Age/Date of Birth
Emergency Name
Emergency Contact Number () -
T-Shirt Size (for information only)
Are you related in any way to a Habitat homeowner? Yes No
If yes, please explain

Employer
Address
Phone () -
Does your employer have a matching grant program for donations and/or volunteer hours? Yes No

Please indicate your affiliations, if applicable:
Church
School
Community

What days are you available to volunteer? (Check all that apply)
Sunday Monday Tuesday Wednesday Thursday Friday Saturday

What time of day works best for you? (Check all that apply)
Morning (8AM-Noon) Afternoon (Noon-4PM) Evening (Special Events Only)

What are your interests? (Check all that apply)
Construction DeConstruction DeConstruction Crew Leader Office ReStore
Fundraising Recycling Cleaning Provide Lunches Media Assistant Special Events
Habitat Family Partner Committees Women Build

Please tell us your skills, talents, experiences, or interests

Is this court-ordered (PTI/DJJ) or probation-required community service? YesNo

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Individual Volunteer Application

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