Mail to: Ulster County Habitat for Humanity               PO Box 2554               Kingston, NY 12402-2554

or

Fax to: 845-689-2480

I have read the information on the qualifications for becoming a Habitat Partner and believe I may qualify. I would like to receive an application to partner with Habitat.

Print Name: _________________________________

Address:  ___________________________________

                  ___________________________________

                  ___________________________________

Signature: __________________________________    Date: _____/_____/_____