Education Participant Application

Do you either live or work in Lake or Sumter County?

* Required

Name and address of current employer (Or state: retired, disabled, etc.)

* Required

First Name

* Required

Middle Name

Last Name

* Required

Address

* Required

Apt / Unit

City

* Required

State

* Required

Zip

* Required

Primary Phone

* Required

Alternate Phone Number

How did you hear about Habitat for Humanity's current educational opportunity?

* Required

Number of Adults in Household:

* Required

Number of Children in Household:

* Required

Total annual Income of all adults living in the home:

* Required

What is your current estimated credit score as of today?*

* Required

Veteran?

* Required

Active Military?

* Required

Disabled?

* Required

Elderly (Over 62)?

* Required

First Responder?

* Required

Are you a First Time Homebuyer?

* Required

Are You Willing to Partner?

* Required

Do you have online access to be able to attend this class virtually

* Required

Are you available from 6-7pm on ALL of the following dates the classes will be held:
March 5th, March 12th, March 19th, March 26th, April 2nd, and April 9th

* Required

Why are you interested in taking this educational course through Habitat Lake-Sumter

Anything else we should know?

Pre-screener date

Please leave this checkbox blank