Construction Applications

We want to thank you for thinking about becoming a part of a Love A Child construction team! Building houses for the poor and displaced earthquake victims in Haiti is a crucial step toward getting these people back on their feet. The fact that you are considering a trip to Haiti to build permanent homes for these people shows that you have compassion for the poor!

Who should I talk to if I have any questions or concerns?
Team members or applicants can call, write, or email Jesse Ostrander, Love A Child’s construction team coordinator at anytime.

Love A Child - Attn. Jesse Ostrander
100 Emerson Dr. NW
Palm Bay, FL 32907
Office: 321-768-2737 • Cell: 813-422-8575
LACbuildingteams@aol.com

Click here to visit our Earthquake Housing Construction page

Important Information about going to Haiti with a Construction Team

Dates for Construction Teams going to Haiti

March 21-26, 2011

April 4-9, 2011

April 11-16, 2011

May 2-7, 2011

May 30-June 4, 2011

June 13-18, 2011

June 27-July 2, 2011

Construction Team Member Application:

Team Name
Date of Trip
Your Name	(As it appears on Passport)
Street Address
City
State
Zip Code
Home Phone	(555) 555-1212
Cell Phone	(555) 555-1212
Work Phone	(555) 555-1212
E-Mail Address
Date of Birth
Age
Sex	Male Female
Birth Place (City, ST)
Marital Status	Single Married Divorced
Occupation
Emergency Contact Name
Emergency Contact Home Number	(555) 555-1212
Emergency Contact Cell Number	(555) 555-1212
Emergency Contact E-mail

Have you ever worked in the field of construction? If Yes, Where:	Yes No
	Masonry flat work Block laying Brick laying Stucco / Plaster work Form work Site prep Heavy Equipment Rough framing Finish Carpentry Steel Crew Insect Control Roofing Metal Roofing Gutters Painting Site clean up Rough Plumbing Finish Plumbing Rough Electric Finish Electric Tractor Trailer

Do you have experience running a construction crew or operating as a foreman? If Yes, explain:	No Yes


Do you have or have you ever been under a doctor’s care for any of the following: If so explain:	Heart Problems Diabetes Difficulty Breathing Back Problems Difficulty Walking Other


Are you able to perform labor in hot weather?	Yes No

Tee Shirt Size	M L XL XXL XXXL

Today's Date
	Please Note: By submitting this form online, you certify all information contained in this application to be correct and to the best of your knowledge.
*Fax: