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* 1. Name (first and last)

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* 2. Which class are you registering for? (Date)

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* 3. Contact Information

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* 4. How did you hear about our class?

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* 6. Race/ethnicity (check all that apply)

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* 7. Marital Status

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* 8. Do you have a disability?

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* 9. Employment Status

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* 10. Household Family Size

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* 11. What is your household monthly income?

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* 12. When are you hoping to buy a house?

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* 13. Have you owned a home in the past?

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* 14. When was the last time you reviewed your credit?

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* 15. Would you like to 

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* 16. What is something you would specifically like to see or learn about in class?

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