Programs

Housing Inquiry Form

Habitat for Humanity of Benton County Inquiry Form

I am inquiring on a Habitat Home and wish to be notified by email when the application process reopens.

*Please note that this inquiry is for the purpose of requesting information only and in no way constitutes an application for a Habitat Home. We will notify you by email when applications are available, and you can check our website at www.habitatbentoncountyar.org.

The information you provide is confidential. By submitting this inquiry, you agree to allow us to collect the demographic data for statistical purposes only. 

If you would prefer to fill out a paper copy of the inquiry form, please click the button below to download a PDF version of the form on this page. You must fill out the form and mail it to the following address: 

ATTN: Cynthia Driggs

Habitat for Humanity of Benton County, Inc.

1212 N. Walton Blvd. 

Bentonville, AR 72712

First Name
Last Name
Acknowledgement of Digital Signature
Do you want to be added to our email list for communication?
Marital Status
Are you a resident of Benton County?
Employed for five years?
Are you a U.S. Citizen?
Are you a Veteran?
Are you disabled?
Are you a senior citizen?
Current Living Situation: Check all that apply