Donate
Sign In
Contact Us
Homebuyer Workshops
Free Counseling Call Now: 1-800-642-2227
Home
How We Can Help
Housing Solutions
Debt Management Solutions
Student Debt Solutions
Credit Report Review
Bankruptcy Counseling
Personal Finance Workshops
Homebuyer Education
Learn About Us
About Us
Our Partners
Board of Directors
Meet The Team
2022 Annual Impact Report
Employment Opportunities
Qualifications & Certifications
Where We Are
Why Us?
Resources
Financial Tools
Blog
Get Started!
My DMP
Menu
Menu
Facebook
Instagram
In Partnership with MNADV
Get Started
Full Name
(Required)
First
Last
Unique ID
(Required)
Phone
(Required)
Email
(Required)
Last Physical Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Date of Birth
(Required)
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Credit Pull Authorization
(Required)
Yes
No
Do we have your permission to continue with the counseling session, release information to assist you and to do a soft pull of your credit report? The soft pull will not affect your credit score.
Are you currently behind on your housing payments?
(Required)
Yes, Mortgage
Yes, Rent
No
What services are you interested in learning more about?
(Required)
Debt Management
Credit Building
Budget Review
Home Purchase
Student Loan Counseling
Rental Resources
Employment Services
Food Savings
Health Insurance / Prescription Savings
Heating / Utility Costs
Child Care
Demographic Information
Highest Level of Education Completed
Elementary School
High School
College / University
Graduate Degree
Choose to Not Respond
Military Status
Active-Duty
Reserves
Veteran
Retired Military
No Military Experience
Choose to Not Respond
Race
African American
White/Caucasian
Hispanic
American Indian/Alaskan Native
Hawaiian/Pacific Islander
Asian & White
African American & White
Other Multi-Racial
Choose to Not Respond
Marital Status
Married
Divorced
Widowed
Separated
Domestic Partners
Choose to Not Respond
# of Dependents Under Age 18
(Required)
Monthly Net Income
(Required)
Housing Status
Rent
Buy
Own
Other
Disclosure
(Required)
I've read and understand this disclosure.
We would like to make you aware that we adhere to the Gramm Leach Bliley Act. This simply means that we do not share any of the information that we will be gathering with anyone other than third parties you authorize us to share the information with to assist you. With your permission we do share information with funders such as HUD and grant providers, however, only aggregate information is used (not personal to you). We are passionate about giving attention to your individual needs and goals for now and into the future so as a CCCSMD client, we pledge that you have the right to prompt counseling services. You have the right to respectful, professional, comprehensive and confidential financial counseling. You also have the right to express dissatisfaction through a compliant process by contacting our office. You have the right to discontinue services with us at any time. Our agency serves all members of the community without discrimination, subject only to eligibility criteria required by funding sources or federal or state law. CCCSMD provides additional services to include housing services like pre-purchase and Reverse Equity Mortgage as well as Student Loan counseling and budget and credit counseling. You are not obligated to use services, referrals or recommendations provided.
Scroll to top