Add Household Profile

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Account Information

*Required - email and password are used when logging into your account.

*Email Address:

*Password: (8-20 characters with no spaces)

*Verify Password: (enter password again to ensure accuracy)

Personal Information *Required

*First Name:

Middle Name:

*Last Name:

*Gender:

*Birthdate: / / (mm/dd/yyyy)

Previously Attended
Boise State:

Former Last Name(s):

*Citizenship Status:

*Country of Citizenship:

Last 4 digits of SSN:

*Home Address:

*City:

*State:

*Zip/Postal Code:

*Work Phone:

*Home Phone:

*Highest Degree Awarded:

*Degree Date:

*University Awarding Degree:

*Highest level of education attained by either of your parent(s) or guardian(s): Highest level of education attained by either of your parent(s) or guardian(s).

Please check if you are Hispanic or Latino Origin:

Online Registration

Add Household Profile