Housing Counseling Services, Inc. Rental Assistance Webinar Registration Form

Please register for the session that works best for your schedule, only one selection will be permitted. Please note, THIS FORM IS NOT AN APPLICATION FOR RENTAL ASSISTANCE. This form will register you for an informational webinar to provide more details about rental assistance programs that are currently available.
















Applicant Information
Primary Applicant




You must be at least 18 years old to register for a course.





Co-Applicant




You must be at least 18 years old to register for a course.




Physical Address

If you do not currently have an address, please enter an address where you can receive mail.





Providing an accurate estimate of your income helps our staff to determine program eligibility. If you have no income at this time, please enter 1 in the income field.



Please include yourself and any other people who live in the house at least 50% of the time in this number.









If you do not receive any e-mails within 5 minutes of submitting this form, please check your junk folder.