Habitat for Humanity of Mahoning Valley

Habitat for Humanity of Mahoning Valley Volunteer Application

What's your email address?

Your information

Required fields are marked with an asterisk (*).
Birthdate *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
First Name *
Last Name *
Mobile Phone *

For example, 123-456-7890
T-Shirt Size *
Address *
City *
State *
Zip Code *
Emergency Contact Name *
Emergency Contact Number *
Retired *
Employer (please type N/A if not applicable) *
Occupation (please type N/A if not applicable) *
Clubs/Organizational/Church Affiliations
School (if under 18) *(PLEASE TYPE N/A IF NOT APPLICABLE)* *
Grade (if under 18) *
Volunteer Interests

I further AGREE ______ DO NOT AGREE ______ to allow any photos taken of me at HFHMV events to be used for HFHMV purposes. *
I represent that I have medical insurance on my own with ____which will cover any and all injuries or medical conditions which must be treated in connection with any and all accidents related to working as a volunteer on a HFHMV project or in a ReStore.