COSMOS Registration

Please provide your basic demographic information to create an account.  This will be the first step to your COSMOS application, and an email will be sent to verify your account. Please note that this registration is just for your initial profile and login. 

Personal Information

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Address

I am a California resident * Help
I am a California resident

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imgPCountry

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imgPState

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Phone Number

International Number

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imgPhoneType

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Demographic Information

imgDOBMonth
imgDOBDay
imgDOBYear

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imgGender

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Preferred Pronoun

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Are you Hispanic or Latino? *
Are you Hispanic or Latino?

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Ethnicity *

Racial/ethnic data is collected and disaggregated solely for reporting purposes. This information is not used for admissions consideration.

Ethnicity

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How did you learn about COSMOS?
How did you learn about COSMOS?

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Error: Please enter valid e-mail address

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Error: Please enter valid e-mail address

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Error: Password must at least 8 characters long, contain at least one number, one capital letter, and one special character.

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Error: The passwords do not match.

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