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Registration Form
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11
Questions
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1
Name
First Name
Last Name
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2
Phone Number
Please enter a valid phone number.
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3
Email
example@example.com
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4
What would you like to register for today?
Request More Information About The Financial Literacy Program
Attend An Event
Request More Information About The Financial Literacy Program
Attend An Event
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5
Select The Event You Plan To Attend:
Credit 101 (2nd Tuesday of Each Month)
Father's Reconciliation
Credit 101 (2nd Tuesday of Each Month)
Father's Reconciliation
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6
Do you need credit restoration for your credit profile?
YES
NO
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7
How would you like to receive the link to attend?
Email
Text Message
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8
Are you looking to establish your credit?
YES
NO
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9
How would you like to be contacted?
Phone
Email
Zoom
Phone
Email
Zoom
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10
You will be redirected to watch a short video about our Financial Literacy Program once you submit this form. Please select "Yes" to indicate you have read this statement. We will still contact you to at your appointment time to discuss the program with you.
*
This field is required.
YES
NO
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11
Please select the best time to contact you
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