Background Screening Form
By filling out this form you agree that Habitat may (but is not required to) conduct any criminal background check or other similar background check as Habitat may deem appropriate. Please note, for required community service, we do not take individuals with sexual or violent charges.
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Email *
Phone number: *
ReStore location where you plan to volunteer (choose one): *
First Name *
Middle Name or Initial *
Last Name *
Suffix (Write N/A if not applicable) *
Date of Birth *
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DD
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Do you need your hours recorded for any reason? (school/community programs/work/court-ordered/lawyer recommended) *
A copy of your responses will be emailed to the address you provided.
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