HAF MODULAR HOME
C/O WWCG INVESTMENTS INC
Main Street, Luganville Espiritu Santo
Vanuatu, South Pacific
www.hafmodularhome.com
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NEW FREE HOMEOWNER APPLICATION:
You must be 100% truthful with this application, untruthful applicants will be excluded from this opportunity..
Do you currently live in an Informal Camp Settlement?
*
Yes, I/We Do
No, I/We Do Not
I/We Are Currently Homeless
I/We Are Currently Living With Friends/Family
Other
Please upload a photo or video of your current home / or where you are living:
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How many people (persons) are there in your family?
*
Please Select
1 - One
2 - Two
3 - Three
4 - Four
5 - Five
6 - Six
More than 6 - Six
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
How did you hear about us?
*
Please Select
Newspaper
Internet
Magazine
Other
Please Specify
*
Tell us in a few words why You and your family deserve a new home:
Are you willing to relocate to a new community?
Yes
No
Maybe
Please give reference of any two people whom you feel best know you:
*
Full Name
Contact Number
1
2
Signature
*
Please verify that you are human
*
Submit
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