Volunteer Registration Form

* indicates required field

1. First Name*
2. Last Name*
3. Age* Select… 16–17 Years 18+ Years

   You must be at least 16 years of age to volunteer.

4. Address
5. City
6. State Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
7. ZIP Code

   5- or 9-digit ZIP code

8. Email Address*
9. Daytime Phone

   Please include area code: xxx-xxx-xxxx

10. Emergency Contact
11. Emergency Phone

    Please include area code: xxx-xxx-xxxx

12. Are you inquiring as an individual or as the representative of a group?

    Individual Group
13. Approximate number in group
14. How did you hear about Habitat?

    Billboards Radio TV/ad/commercial TV/newscasts Newspaper Church/place of worship Friends/family School/university Internet/website Nashville Area Habitat newsletter Nashville Area Habitat homeowner Service Fair Other:

1. Construction

   Construction Volunteer Supervisor On Site (SOS)
2. Family Services

   Budget Coach HomeWORKS Instructor HomeWORKS for Kids Instructor HomeWORKS for Kids Volunteer
3. HomeStore

   Casual Volunteer Recurring Volunteer
4. Office

   Administration
5. Youth United

   Sponsor Youth Leader
6. Large Group

   Wall Panel Build Tree Planting

1. Comments