Renter's Education Registration
Register for Renter's Education
What is your Name? *
Your answer
What is your Date of Birth? *
MM
/
DD
/
YYYY
Which workshop are you interested in? *
Required
What is the date of the workshop?
MM
/
DD
/
YYYY
Please provide a phone number and/or email account for us to contact you. *
Your answer
What is the best way to contact you?
How did you hear about this workshop?
Your answer
These questions are for potential referrals for other Community Action services and resources. They do not impact your registration.
Yes
No
More information please
Have you ever served in the United States Military?
Is anyone in your household pregnant or have children under five years old?
Do you receive Basic Food Assistance?
Are you seeking employment?
Do you receive Energy Assistance?
Are you interested in getting your GED?
Are you interested in meeting one-on-one with a Financial & Job Coach to set, clarify, and maintain your goals?
Submit
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