Housing Interest Form livepage

Housing Interest Form

Habitat for Humanity believes that by building houses with those in need, and by working with other committed groups, the poverty housing problem can be alleviated significantly.

Your Contact Information

Please review the Applying to Habitat page to ensure you meet our guidelines before submitting this form to Habitat. Note that this Interest Form is NOT an application for a Habitat home, but instead provides us with your contact information which we will use to notify you about our next Home Interest Meeting. You will receive your application at the meeting.

Your First Name (required)

Your Last Name (required)

Street Address (required)

City (required)

State (required)

Zip Code (required)

Your Email address

Your Home Phone

Your Cell Phone

Your Work Phone

Number of Family Members (required)

Number of Adults (required)

Number of Boys (children)

Number of Girls (children)