Stand Sure Credit Counseling Enrollment Form

Welcome! Please use the form below to enroll in our online credit briefing and certificate course.

$29.95 for Single / $29.95 for Joint (Online Version)
$29.95 for Single / $29.95 for Joint (Telephone Version)

Alabama Rate - $29.95 (Single or Joint)

 * required fields
** required fields for Joint users

* Please provide the following information:
  I need Credit Counseling for myself only (Single)
  I need Credit Counseling for myself and my spouse (Joint)

Telephone Clients ONLY

To receive a credit briefing via Telephone, please download the packet using the link below. Print the packet and follow the enclosed instructions. If you wish to receive your credit briefing via Internet, please use the form on this page to provide us with your information.


    Disclosures and Fee Waiver Policy
    * Accept     Decline    

  STUDENT #1  
* First Name:  
** First Name:  
Middle Name:  
Middle Name:  
* Last Name:  
** Last Name:  
* Username:  
** Home Phone:  
* Password:  
Work Phone:  
* Confirm Password:  
Cell Phone:  
* Home Phone:  
** Date of Birth:  
Work Phone:  
** SSN No. (last 4 digits):   
Cell Phone:  
** Email:  
* Date of Birth:     
** Confirm Email:   
* SSN No. (last 4 digits):  
* Email:  
* Confirm Email:  
* Judicial District:  
    Student Mailing Address (not the Bankruptcy Court address)
* Address:  
Address 2:  
* City:  
* State:  
* Zip:  
* Do you have an Attorney?   Yes   No
** the following attorney fields are required if you answered yes above.
** Attorney Name:  
** Attorney Phone Number:   --
Attorney Email:  
Attorney Firm:  
Attorney Address:  
Attorney City:  
  Fax a copy of my certificate to my Attorney?
Attorney Fax:   --

This Credit Briefing is for persons who are considering bankruptcy and need a Certificate of Credit Counseling. The accompanying certificate meets the bankruptcy court requirement. When you complete the counseling, your Credit Counseling Certificate is available the same day.

The information provided in this Credit Briefing is a general discussion of the subject matter and is not a legal opinion about your particular situation. For further advice, assistance, or informationn, please consult an attorney.

* Approved to issue certificates in compliance with the Bankruptcy Code. Approval does not endorse or assure the quality of the Agency's services.