Level With Us

Level With Us: Tell us your story so we can help others.

Thank you for taking the time to share your story with us! Level With Us is our ongoing campaign to collect stories of how Homeport has touched lives and made a difference. There is no better way to illustrate what we do.

 

 
1.

Please enter your contact information indicated below. Your mobile number can substitute for Home Phone if it is more convenient.

 

 


First Name:
Last Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

2.

What is the best day & time to contact you?

 

 

350 characters left.
3.

What is the best way to contact you?

 

Telephone
E-Mail
4.

Which describes your relationship with Homeport? Please check all that apply.

 

Volunteer
Donor
Resident
Home Buyer
Client (attended classes, received counseling, met with service coordinator)
Other  
5.

Please share a brief summary of your story: (Include information about how your interaction with Homeport enriched your life or improved your situation)

 

 

1000 characters left.
6.

I voluntarily agree to share my story with Homeport.
I understand and agree that this statement may be used for any and all publicity, marketing, media projects and public relations. In the event that any part of my story is published, I wish to:

 

Remain anonymous
Have my first name and last initial used
Use my full name