Register Online: CreditSmart

An asterisk (*) denotes a required field.

For a printer-friendly application that you can fill out on paper, click here. Select a Workshop: Please select a workshop Click here for workshop dates and locations.
Your Name *	first: last:
Second person attending:	first: last:
Street Address *
Town/City *
Zip Code *
Daytime Phone	()- ext:
Evening Phone *	()- ext:
Email Address
My exact household income is.. *
I own a.. *	Single Family Two Family Three Family Condo Other:
Ethnic Background	White   Black   Hispanic   Asian   Other
Family Size *
Female Head of Household Elderly
How did you hear about MAHA? *

When you are done, click on "Submit" once. You may have to wait up to one minute, then you will see a confirmation message.

Please return this form as soon as possible. Space is limited and reserved upon receipt of registration form.
If you have any questions, please call (617) 265-8995 x308.
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