| Counseling Registration Form |
| All Fields Below Are Required |
| Counseling Session: | Pre-Home Purchase |
| Counseling Language: | |
| Late on Mortgage: | |
| Have you previously contacted the Hope Hotline or any other counseling? | |
| First Name: | |
| Last Name: | |
| Address: | |
| City: | |
| State: | Florida |
| Zip: | |
| County You Currently Live: | |
| Phone: | |
| Best to Call You: | |
| Email Address: | |
| Confirm Email Address: | |
| Race: | |
| Age: | |
| Marital: | |
| Family Size: | |
| Household Income: | |
| Sex: | |
| Ethnicity: | |
| Referred by: (Type if applies - This information is optional) |
| Church Name: | |
| Lender: | |
| Builder: | |
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How does it work:
Step 1:
Fill the web form here to the left. If this one is successfully
sent you will see a 'Thank you' page.
Step 2:
HANDS will process your registration and further contact you either by email or phone
to set up an appointment for private counseling at our Administrative offices.
Step 3:
Your HANDS Counselor will give you a reminder call the day prior to your
Counseling session and review with you the information to bring for counseling.
Important: This type of counseling may not be available for 3-15 days. HANDS has a backlog of clients we are currently trying to serve.
Importante: Este tipo de consejeria no estará disponible por los proximos 3-15 días. HANDS tiene muchos clientes en lista de espera a los cuáles estamos tratando de atender.
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