HECM Housing Counselor Registration

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Are you registering as a member of the FHA HECM Counselor Roster?	Yes
Are you registering as an FHA Connection Application Coordinator for the HECM housing counseling agency that employs you? Yes		If yes, please enter your agency ID:

First Name:
Middle Initial:
Last Name:
Social Security Number:	- -
Telephone Number:	- -

Provide your e-mail address.

Include your e-mail user name, the @ sign and [servicename.com/edu/org/net/etc.]. For example: jsmith@aol.com, johndoe@adv.org, hfdb84a@prodigy.com

E-mail Address:
Re-enter E-mail Address for Verification:

Choose a Password.

You will enter your password each time you use this service. Your password must be exactly 6 characters in length and should be comprised of letters and at least one number (for example, brad83), and may include "-" and "_". Important: At your first sign on to the FHA Connection, you will need to enter the password you record on this registration form EXACTLY as you typed it, e.g.,with upper and lower case letters, etc.

	Password:
	Re-enter Password for Verification:

Mother's Maiden Name.

Please provide this information for future verification when processing password reset requests.

Mother's Maiden Name: