Renter to Homebuyer Education Workshop Registration

Due to COVID-19, all future workshops will be offered virtually until further notice. PLEASE PROVIDE AN ACCURATE EMAIL ADDRESS TO ENSURE YOU ARE PROPERLY REGISTERED FOR THE VIRTUAL WORKSHOPS.

Workshop Schedule 9am - 3 pm

Please choose the date of the Workshop you wish to attend: *

Participant Information

Are you a previous D&E client? *

Yes

No

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Postal Code *

County *

Phone *

Email Address *

Birthdate *

Age *

Include my contact information on lists distributed to other attendees.

Yes

No

Co-Applicant *

No

Yes. Enter the Co-Applicant name Yes. Enter the Co-Applicant name

Co-Applicant email address *

Race *

Are you Hispanic? *

Yes

No

Are you English proficient ? *

Yes

No

Gender *

Male

Female

Do you live in a rural area ? *

Yes

No

Number in Household *

Gross Monthly Income *

Household Annual income *

Veteran ? *

Yes

No

Active Military? *

Yes

No

Disability? *

Yes

No

1st Time Homebuyer ? *

Yes

No

1st Generation Homebuyer ? *

Yes

No

Foreign born ? *

Yes

No

Household type? *

Marital Status *

Head of household ? *

Yes

No

Residency Status *

Rent

Own

Highest Level of Education *

Lender Information

Are you currently working with a lender? Y/N *

Yes

No

If yes, please provide their contact information below:

Name

Company

Phone Number

Email

Additional Services Needed

Please indicate below any additional services that you may interested in, by checking the boxes below. *

How did you hear about this workshop?

Select an option below: *

I understand and agree that this is a virtual workshop of 5 hours and that in order to satisfy the 6-8 hour HUD requirement to obtain my Certificate of Completion, I must complete the 1-on-1 pre-purchase/rental counseling. *

All of the information that I/We have provided in this worksheet is correct and factual. No information has been withheld. We understand the necessity for accurate and complete information in obtaining a favorable workout / resolution. We will provide any needed information to assist the housing counselor. We understand that deliberately providing inaccurate information or an unwillingness to timely provide the counselor with the necessary information or documents to assist us can result in an adverse result. It will also result in closing of our file and no further assistance from the counselor will be provided.

Signature Date * 🛈

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Please ensure that all information above is accurate and true before clicking Continue. Your confirmation will be emailed to the individual and email address listed above.