Homeowner Orientation Registration

TBR Huge Plant & Rummage Sale
September 11, 2010 (7:00 AM)

Thrivent Build Groundbreaking
September 11, 2010 (7:30 AM)

Recent Events

Home Maintenance Workshop
August 21, 2010 (8:00 AM)

Thank you all for your support and contributions.

First Name *
Last Name *
Daytime Phone *
Mobile Phone
Evening Phone
Mailing Address
Email
Household Income
Household Size
	Have you lived in Leon or Gadsden County for 12 months or more? YesNo
	Have you had the same job or verifiable income for 6 months or longer? YesNo
	Are your current living conditions substandard such as overcrowding or poor condition or high crime area? YesNo
	Are you willing to make a small down payment of 500 dollars? YesNo
	Are you willing to live on a lot provided by Habitat? YesNo
	Do you understand and agree that the house size is based on the household size? YesNo
Additional Comments
	Please enter the code you see in the image below

Big Bend Habitat for Humanity