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Add Primary Household Profile

We encourage families to set up Household Profiles to include all members of their family.
Enter basic information about your household on this screen.
The next required screen will ask for information about individuals in your household.
 

 

* denotes required information.
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You will use your email address as your username on this site.
 Privacy Policy
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Password: minimum 8 characters, must contain a number and any two of the following three: upper case, lower case, special characters (for example: (){}!@$%^&*)
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Mail preference
May we include you on our mailing lists?
Yes No

If your company is not available in the list, select ** Add Company ** and you will be prompted to add your company's information after submitting this form.
Cancel
Cancel
Primary Address
 
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Secondary Address
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Additional phone
 
 
E-mail Preference
Yes No
Receive course related info via e-mail?
Level of Education
Job Title

Type or area of employment
Birthdate*
How did you hear about us?
Catalog
Website
Newspaper Ad
Newspaper Catalog Insert
Internet Search
Direct Mail to Home
Direct Mail to Work
Media
Word of Mouth
None specified
Gender*
Male Female
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© 2024 Columbus State University

Elizabeth Bradley Turner Center • 4225 University Avenue • Columbus, GA 31907
*Located at the corner of East Lindsay Dr. and College Dr.
Directions

assistance@columbusstate.edu
706-507-8070