| Customer
Information
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Enter a NEW password & username. Use something that you have never used on this page. |
| Username
: |
(Enter a simple one-word user name and remember this for logon purposes)
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| Password : |
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| Confirm
Password : |
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| Email
Address : |
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| Confirm Email Address
: |
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| First Name :
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| For
salespersons Exactly as shown on your TDHCA license or for others as shown in
TDHCA Records for a principal or related person
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| Middle Name
or Initial : |
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| For
salespersons Exactly as shown on your TDHCA license or for others as shown in
TDHCA Records for a principal or related person
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| Last Name
: |
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| For
salespersons Exactly as shown on your TDHCA license or for others as shown in
TDHCA Records for a principal or related person
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| Name Suffix
: |
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| For
salespersons Exactly as shown on your TDHCA license or for others as shown in
TDHCA Records for a principal or related person
|
| Licensee’s
Home Street Address : |
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| City
: |
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| State
: |
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| Zip Code : |
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| Your
personal phone # : |
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| Your
sponsor or your company's Name : |
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| Location
Street Address : |
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| Location
City : |
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| Location
State : |
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| Location
Zip Code : |
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Leave the next two boxes blank if you are not a salesperson.
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| Salesperson - Insert
your TDHCA License # : |
MHSLSP000
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| Expiration Date : |
(MM/DD/YYYY)
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| Your sponsor’s
TDHCA license or your company’s TDHCA license number :
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| Your Sponsor's TDHCA License #
or Your Company's TDHCA License #: (AS SHOWN ON LICENSE)
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| For Retailers - License
#:
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MHDRET000
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| Expiration Date : |
(MM/DD/YYYY)
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I
certify that I am the person who holds this salesperson
TDHCA license or I certify that I am qualified to take
this course as a principal, owner, partner, officer, or
a RELATED person registered with TDHCA on the license
application and that I am the person who will complete
this Continuing Education Course online. I further
certify that all the information provided on the
registration page and any oother personal information
that I may provide TXMHS while taking this online course
is true and correct to the best of my knowledge. I have
read and understand TXMHS’S payment / refund
policy and
I agree to abide by the terms therein.
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