Families - Sign up for the Next Orientation

Applicant Orientation Session Registration Form

Next Orientation Session:
June 9 2011; 6:30-8:30pm, Sidney Pollack House - 450 East High Street, Pottstown, PA.

Habitat holds orientation sessions four times a year. The application process begins at these orientation sessions. To attend one of our orientation sessions, fill out the form below and hit submit (once).

For more information, please contact our Family Services Coordinator at (610) 278-7710.

* = Required Field

Contact Information

Applicant First Name *

Applicant Last Name *

Co-Applicatn Name (if any)

Street Address *

City *

State / Province *

Zip / Postal Code *

Telephone *

Email *

Additional Information

How did you hear about us?

Do you live in Montgomery County?

Do you work in Montgomery County?

Family Size

List special needs (if any)

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