First Name* 

Last Name* 

Street Address* 

City* 

State* 

Zipcode* 

Email* 

Home Phone 

Cell Phone 

Work Phone 

 I do not want to receive mailings

 I would like to subscribe to the Building on Faith eNewsletter

Date of Birth (mm/dd/yyyy)* 

Gender
 Male
 Female

I am 16 years or older
 Yes
 No

Are you retired?
 Yes
 No

I can volunteer on
 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
 Sunday

How did you hear about Habitat? 

Occupation 

Employer 

Place of Worship (optional) 

Language(s) 

Please list any professional experience in a construction-related field

Please mark your area(s) of interest
 Construction Volunteer
 Construction Leadership
 Hospitality
 Site Refreshments
 Women’s Build
 ReStore Volunteer
 Office Volunteer
 Joining a Committee
 Fundraising
 Event Planning
 Advocacy
 Faith Relations
 Youth Programs
 Newsletter & Media
 Grant Writing
 Other

Please list any specific experience you have with the marked items above

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