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Create New Student Profile

The following information is required so that we can successfully register you and process certificates when you complete a course.

*You may use an email address as your Username.

* denotes required information.

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E-mail*

You will use your email address as your username on this site.

Re-enter E-mail*

Password*

Password: minimum 12 characters, must contain a number and any two of the following three: upper case, lower case, special characters (for example: (){}!@$%^&*)

Strength

Re-enter password*

Password hint*

Identity Verification Question*

Identity Verification Answer*

First name*

Middle Name

Last name*

Birth / Other Name

Primary Address

Primary Address Type*

Country*

line 1 > Address*

line 2 > Address

City*

State*

Province *

Zip*

Zip+4

Secondary Address

Same as Primary Address

Secondary Address Type

Country

line 1 > Address

line 2 > Address

City

State

Province

Zip

Zip+4

Phone*

Additional phone

Gender*

Male
Female
Prefer Not to Answer

Date of Birth*

Cancel

Drivers License Number

Social Security Number

Race*

Ethnicity*

Educational Level*

Resident

Yes No
Are you a local resident or meet residency status?

Employed?

Are you currently employed?

Are you a Veteran?

‘Click-Ctrl’ to select multiple options

Cancel

Mail preference

May we include you on our mailing lists?

Yes No

Center Compact Member (BI Code)

Employer

The company you work for.

Cancel

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