VOLUNTEER Questionnaire for  
                      Habitat for Humanity Española Valley & Los Alamos, Inc.

Name __________________________________________________   Birth Date (optional)_______________
                            (Last)                                   (First)
Address __________________________________________________________________________________
                      (Street)                                                   (City)                           (State)          (Zip)
Telephone (H)______________________ (W)_______________________ (Cell)_______________________

Occupation _____________________________  Employer ___________________________________

Date____________    E-mail Address __________________________________________________________

Referred by _____________________ Best way to contact you (circle one): Telephone (home or work) / Email

SERVICE OPPORTUNITIES (Through my involvement, I would like to use my skills to make a difference…)

___Job Site
___ Construction crew leader       ___ Site Host (help with breaks, lunch , registration, questions – Saturdays 8am -1pm )
___ Presentations
___ Grant Writing
___ Fund Raising Projects
___Office Volunteer (weekdays)
___Family Partner (work w/prospective Home owner(s) from selection through 1^st year of home ownership)
___Pro bono Basis
___Special Events
__Donate money or materials ________________

COMMITTEE OPPORTUNITIES  Committees generally meet one evening a month and create strategies and plan activities.
                                                    Due to the variety of committee opportunities and procedures please check if you are interested in finding out more.