Somerville Community Corporation

337 Somerville Ave, 2nd Flr Somerville, MA 02143 • Phone: 617-776-5931 • Website:

First-Time Homebuyer Online Seminar Registration

Please complete registration and email to Shannon Erb at .

Month of in-person session you are registering for: ______

Name: ______
Address: ______
City, State & Zip: ______
Phone: [cell] ______
Phone: [home or work] ______
Email: ______
Last 4 #SS: ______/ How did you learn about class?
Someone who took a class
Agency/Organization
Lender/Mortgage Co.
Friend/Relative
Mailer/Flyer/Brochure
Internet
Newspaper
Other: ______
  1. Age
20 - 30 yrs
31 - 40 yrs / 40 - 50 yrs
51 - 60 yrs
60 + yrs /
  1. Gender
Male
Female
Are you:
  1. A veteran?
  2. Disabled
  3. Head of household?
/ YesNo
YesNo
YesNo /
  1. Have your parents or grandparents ever owned a home in the U.S.?
YesNo
  1. Ethnicity:
Hispanic/Latino
Non-Hispanic/Latino
Race: (Please select one)
Single race categories:
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Multi-race categories
American Indian or Alaskan Native andWhite
Asian and White
Black or African American andWhite
American Indian or Alaskan Native and Black or African American
Other Multiple Race /
  1. Highest level of education completed:
Less than high school graduate
High School Graduate/GED
2-yr college
Bachelors degree
Graduate school/degree
  1. Have you seen a copy of your credit report
    in the last year?
YesNo
  1. Do you know your credit score?
YesNo
  1. Household size:
  2. Numberof adults:
  3. Number of children:


  1. Annual Household Income:

Class registration is $100.00 per person; you will not receive the online link until payment is made. Space is limited and reserved upon receipt of registration form and payment. Please email a completed form to Shannon at . Please note all registrations are finalonce confirmed; we do not offer refunds.
SCC OFFICE USE ONLY:
Date Rec. Counselor PYMT#
SCC will use this information to evaluate the 1st Time Homebuyer Education workshops and learn more about the characteristics of who the program is serving. Information collected on this form is confidential.