REGISTRANT PROFILE
 

   Please enter the requested profile information for the person registering for the course.

   * denotes a required field


 
 *
 *
 Last Name titles such as Jr, II, PhD
 Required if registrant is a minor
 If applicable

Billing Address

 Apt./Suite or additional address details
 Enter 0 for non US addresses without State
 Enter zero for non US addresses without postal code

Mailing Address

 *
 Apt./Suite or additional address details
 *
 *  Enter 0 for non US addresses without State
 *  Enter zero for non US addresses without postal code
 *

 *
 *
 *
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*
  AARP:
Members of AARP
  CCSU Alumni:
Alumnus of Central Connecticut State University
  CCSU Employee:
  CCSU Student:
Current CCSU Student
  Speaking Series:
For those who have purchased the current Life & Leisure membership
  Standard:
All others

For new accounts, add User Name and Password.

Password Requirements:
* From a minimum of 8 to a maximum of 15 characters - case sensitive
* Special characters allowed: !#$%&()*+,-./:;<=>?@[\]^_`{|}~

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*
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