Harlem PACT Section 3 Hiring Survey Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. Street Address Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 4. Are You At Least 18 years old? Yes No Question Title * 5. Have you ever worked on a Construction Site? Yes No Question Title * 6. Do you have a valid OSHA 40 certificate? Yes No Question Title * 7. Name of NYCHA Development or Residence? Question Title * 8. Are you listed on the lease/family composition with NYCHA? Yes No Done