Homebuyer Education Workshop
Registration Form
Please select the date of the class you'd like to register for?
*
Please Select
September 12, 2026 - Rancho Cucamonga
October 3, 2026 - Rancho Cucamonga
November 7, 2026 - Rancho Cucamonga
Primary Applicant Name
*
First Name
Last Name
Primary Applicant Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Applicant Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Primary Applicant Email
*
Confirmation Email
Confirm Email
Primary Applicant Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Applicant Race
*
Please Select
American Indian/Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
More than one race
Choose not to respond
Primary Applicant Ethnicity
*
Please Select
Hispanic
Not Hispanic
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Primary Applicant Gender
*
Please Select
Male
Female
Other/Non-Conforming
Primary Applicant Marital Status
*
Please Select
Unknown
Married
Single
Divorced
Separated
Widowed
Choose not to Respond
Are you a First Time Homebuyer?
*
Yes
No
What is your Rural Area Status?
*
Please Select
Live in a Rural Area
Do not live in a rural area
Choose not to respond
What is your Household Size?
*
What is your Highest Level of Education?
*
Please Select
None
Elementary/Primary
Junior High School
High School/GED
Junior College
University
Graduate School
Vocational
College
Other
Do you have a Co-Applicant?
Yes
No
Co-Applicant
Co-Aplicant Full Name
*
First Name
Middle Name
Last Name
Email
*
Confirmation Email
Confirm Email
What is your Relationship to the Primary Applicant?
*
Please Select
American Indian/Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
More than one race
Choose not to respond
What is your Gender?
*
Please Select
Male
Female
Other/Non-Conforming
What is your Rural Area Status?
*
Please Select
Live in a Rural Area
Do not live in a rural area
Choose not to respond
Co-Applicant Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about NPHS?
*
Please Select
Bank/Lender
City or County
Facebook
Friend
Newspaper
NPHS Staff/Board Member
Online Search/Google
Radio
Realtor
Television
Walk-in
Today's Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
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