Date______________________
 

Personal Information

Name_________________________________________________________________________________

Address_______________________________________________________________________________

City_____________________State___________________Zip Code_______________________________

Email Address__________________________________________________________________________

Phone__________________________Business__________________________Other_________________

Are you over the age of 15?____________________Occupation__________________________________

Current Employer_______________________________________________________________________
 

Background/Skills

Languages spoken_____________________Leadership positions held______________________________

Construction Experience__________________________________________________________________

Other related skills______________________________________________________________________

Please indicate skills or trades below with the following letter
N=Novice (no prior experience
A=Amateur) Hobby, non-employment)
P-Professional (Prior employment experience)

Brick Layer____   Framing___  Sheetrock___
Carpentry Finish____  HVAC___  Siding___
Cleaning____   Insulation___  Tile___
Concrete____   Landscaping___ Vinyl Flooring___
Dry Wall____   Painting___  Windows____
Electrical____   Roofing___  Other____

How did you hear about Habitat for Humanity?
Newspaper____ Mailing list_____ Friend ______ Television______ Internet_______