Contact information

First name

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Last name

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Phone

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Phone type
Email address

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Questionnaire

Date of Application

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Date of Birth

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First Name

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Last Name

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Middle Initial

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Street Address

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City

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State

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Zip

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Home Phone

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Cell Phone

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E-mail Address

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Is this School/Court driven Community Service

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Do you have any particular skill sets that we should know about?

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Are you interested in working on a build site/home repair opportunites?

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Are you interested in ReStore Opportunities?

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Other Volunteer Opportunities?

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What days of the week are you available to volunteer?

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What times are you available to volunteer? The ReStore has volunteer opportunities available Tuesday-Friday between 10am-5pm, and Saturday 9am-4pm . The build site has volunteer opportunities on Wednesdays, Fridays and Saturdays 8:30am-3:30pm

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How many hours do you hope to volunteer each week?

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In connection with my service with Habitat for Humanity Lakeside and Habitat for Humanity Lakeside ReStore, Ihereby authorize Habitat for Humanity Lakeside to conduct a criminal background check on my behalf. Iunderstand that my ability to volunteer with Habitat for Humanity Lakeside is contingent upon the results of thebackground check. I understand that I am entitled to receive and review the information obtained, upon request.

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EMERGENCY CONTACT First Name

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EMERGENCY CONTACT Last Name

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EMERGENCY CONTACT Phone Number

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