High School Co-Op Inquiry Form

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Please register your interest for obtaining a co-op placement at Habitat for Humanity - Halton-Mississauga-Dufferin. Once we receive your form we will be in touch to discuss the next steps of the application process.

Email *

First & Last Name: *

Email address: *

Telephone number: *

Date of Birth: *

What school do you go to? *

What is your teacher's name, telephone number and/or email address? *

Which location would you like to do your co-op at? *

Burlington

Milton

Mississauga

Orangeville

Remote Role

How many hours are you required to complete for your co-op credit(s)? eg. 150hrs per semester *

Would you like to have your placement in the morning or afternoon? *

Morning

Afternoon

What are the start and finishing dates for your placement? Example - September 4th - December 20th or July 5th to August 10th *

Why would you like to do your co-op at Habitat for Humanity? *

Do you have any restrictions or special requirements that we should be made aware of? *

Have you ever been charged or convicted of a criminal offence, or convicted of a past offence for which a pardon has not been granted? *

If yes, you will be required to speak with our Manager of Volunteer Services regarding the charges, even if pending.

Yes

Other:

Send me a copy of my responses.

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