HOMEOWNER INQUIRY FORM

SOUTH COUNTY HABITAT FOR HUMANITY HOMEOWNER INQUIRY FORM

"Through Shelter, We Empower !"

Please note that this inquiry form is not an application for a Habitat home.

This provides us with your contact information so we can notify you when we have our next Homeownership Opportunities.

NAME(S): *

DATE:

Date

STREET ADDRESS *

APT/UNIT#

PO BOX:

CITY: *

STATE: *

ZIP: *

PREFERRED PHONE: *

ALT. PHONE:

EMAIL:

FAMILY SIZE:

HOW DID YOU HEAR ABOUT HABITAT?

Your information will be kept active in our database for one year. To remain active and to ensure your records are current please re-submit this form each year by January 31st or call the Habitat office at (401) 213-6711. *Be sure to call us immediately if your address changes, so that we may update our records*