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Habitat for Humanity of Pike County PA

Applications

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Homeowner Pre-Application

 

Use the below form to send us the pre-application information by email but the pre-application on the previous page MUST also be printed, signed and mailed or delivered.

Pre-Application to Print and Send In

 
I have read the pre-application guidelines on the previous page and I believe my family qualifies for consideration for Habitat ownership. Please send me an Application for Housing.

Prefix (check one)

Mr. Mrs. Ms. Miss.

  First Name

Middle Name/Initial

Last Name

Address Line 1

Address Line 2

City

State

Zip

E-Mail

Home Phone

Work Phone

Comments 

   
 
 


 

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16 Delaware Crest - Dingmans Ferry PA 18328 - (570) 828-1623 - Fax: (570) 828-2346
hfhpc@ptd.net - www.hfhpc.org