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Volunteer Application

Please provide the following contact information:

*Required Fields

*Name of
Organization
*Contact Person
   
*Street Address
or P.O. Box
Address Line 2
*City
*State/Province
*Zip/Postal Code
   
Work Phone
Home Phone
*E-mail
Best time to
contact you

What dates would you like to volunteer?

Which volunteer opportunities are you interested in? Please check all that apply.
Repair Affair (for local volunteers)
Community House Raising (for local volunteers)
Other Community Event (for local volunteers)
House Raising Challenge (for both local & non-local volunteers)
Hammerin’ in the Hills (for non-local volunteers)
Other non-local volunteer opportunity

How many people are you planning to bring?

Jr. High
Sr. High
College
Adults
TOTAL

Are there any special needs in your group that we need to be aware of? If so, please explain.

Previous Mission/Work Trip Experience (Not required)

Construction Skills/Experience (Not required)

Please include any other interests (cultural, educational, recreational, etc.) you may have for your group:

How did you find out about the Housing Development Alliance?

If other, please specify:
Housing Development Alliance

Jane Rose Britton,
Volunteer Coordinator

Phone: (606) 436-0497
TTY-711 (Hearing Impaired)
Fax: (606) 436-0598

P.O. Box 7284
Hazard, Kentucky 41702
member of fahe
 606.436.0497
HDA, Inc.
P.O. Box 7284, Hazard, KY 41702
TTY-711 (Hearing Impaired)
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