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

Account Information
Your email address will serve as your username when logging in going forward.

* 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

*If you do not know your credit score please visit Experian.com to retrieve your free score prior to proceeding.

How many members of your household are...

Veteran?

* Required

Active Military?

* Required

Disabled?

* Required

Elderly (Over 62)?

* Required

First Responder?

* Required

Are you a First Time Homebuyer?

* Required

This education opportunity requires a partnership with Habitat for Humanity including attending each education course in the series and doing the requested tasks to ensure you are engaged in the class. Are you willing to partner with Habitat Lake-Sumter and commit to this education course. Based on this...

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 the following dates the classes will be held:
March 6th, 13th, 20th, 27th, April 3rd, 10th

* 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