Skills and Interests Survey

Name ___________________________________________________________________________.

Address _________________________________________________________________________.

City ____________________________________ Prov ________________ Postal Code _________.

Home/Cell Phone ________________________________ Work Phone _______________________.

E-mail Address ____________________________________________________________________.

Church Affiliation (if any) _____________________________________________________________.

Occupation (or name of school if student) _________________________________________________.

Organizational or civic affiliations ________________________________________________________.

_________________________________________________________________________________.

Check if you would be willing to serve on the Board of Directors or one of the listed committees:

_____ Board of Directors _____ Family Selection _____ Church Relations

_____ Building _____ Family Support _____ Nominating

_____ Development _____ Safety _____ Site Selection

Check area(s) where you are skilled (or would like to volunteer). Indicate your skill level next to

checked items: [P] 1 = highly skilled (professional) 2 = semi-skilled 3 = unskilled

[ ]____public relations [ ]____grant writing [ ]____site preparation

[ ]____fundraising [ ]____data entry [ ]____foundation preparation

[ ]____mailings [ ]____newsletter [ ]____landscaping

[ ]____photography [ ]____legal work [ ]____roofing

[ ]____accounting [ ]____volunteer recruitment[ ]____painting

[ ]____public speaking [ ]____artwork [ ]____insulation

[ ]____music for a Habitat event [ ]____finish carpentry [ ]____heating/air conditioning

[ ]____sewing [ ]____framing [ ]____concrete finishing

[ ]____cooking for workdays or [ ]____plumbing [ ]____electrical

special events [ ]____crew leader [ ]____siding

[ ]____house leader

Print this form and mail to:

P.O. Box 23021
Penticton B.C. V2A 8L7