2024 BUILD SEASON HOUSING INTEREST FORM
This is NOT the worksheet!

Please complete this form; someone from our Homeowner Selection Committee will contact you soon.
They will inform you about our homeownership program and explain the process.

Equal Housing Opportunity: “We are pledged to the letter and spirit of US policy for the achievement of equal housing opportunity throughout the nation. We encourage and support an affirmative advertising and marketing program in which there are no barriers to obtaining housing because of race, color, religion, sex, handicap, familial status, or national origin.”

Questions? Call 719-395-0482

First Name *

Last Name *

Email *

Today's Date/Date Interest Form Completed * The date field Today's Date/Date Interest Form Completed is required.

Mailing Address * The field Mailing Address is required.

City, State & Zip Code (Mailing) * The field City, State & Zip Code (Mailing) is required.

Physical Address The maximum length for the field Physical Address is 500 characters.

City, State & Zip Code (Physical) The maximum length for the field City, State & Zip Code (Physical) is 500 characters.

Primary Contact's Phone Number * The field Primary Contact's Phone Number is required.

Secondary Phone Number The maximum length for the field Secondary Phone Number is 500 characters.

Secondary Contact's Information

List the name & contact information of another adult living in the household.

Secondary Contact's First Name The maximum length for the field Secondary Contact's First Name is 500 characters.

Secondary Contact's Last Name The maximum length for the field Secondary Contact's Last Name is 500 characters.

Secondary Contact's Phone Number The maximum length for the field Secondary Contact's Phone Number is 500 characters.

Household Information

# of Adults in the Household * The field # of Adults in the Household is required.

# of Children in the Household * The field # of Children in the Household is required.

Alternate Contact Information

Please provide the name and contact information of a person who can help us reach you and who does not live in the household.

Alternate Contact's First & Last Name The maximum length for the field Alternate Contact's First & Last Name is 500 characters.

Alternate Contact's Phone Number The maximum length for the field Alternate Contact's Phone Number is 500 characters.

Alternate Contact's Email Address The maximum length for the field Alternate Contact's Email Address is 500 characters.

How did you hear about Habitat for Humanity?

How did you hear about Habitat?

Friend's Name? The maximum length for the field Friend's Name? is 500 characters.

Church's Name The maximum length for the field Church's Name is 500 characters.