City of Shreveport Community Development

monet.bryant@shreveportla.gov

401 Texas Street
Shreveport, LA 71101

318-673-5900

Gender

Date of Birth

Age

Ethinicity

Black

White

Hispanic

Asian

Marital Status

Single

Married

Separated

Divorced

Widowed

Last 4-digits SSN#

Home Phone

Cell Phone

Work Phone

Are you a first-time homebuyer?

Yes

Are you currently working with an agent?

Yes

How did you hear about the workshop?

Would you like more information about the program?

Yes