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YOUR INFORMATION
Please enter the following information about yourself.
First Name: *
Middle Name:
Last Name: *
Employer:
Job Title:
Address Line 1: *
Address Line 2:
City: *
Country: *
State / Province / Region: *
Zip / Postal Code: *
 
Phone Type International Phone Number Extension
Primary Phone:
Note: Phone number is required to
pay online via your checking account
      
Alternate Phone 1:
      
Alternate Phone 2:
      
Alternate Phone 3:
      
E-mail Address: *
Verify E-mail Address: *
Date of Birth: (mm/dd/yyyy)
How may we contact you: *
Do you require special
accommodations due to disability or religious reasons?
If so, please describe the
accommodations you require:

PLEASE NOTE: For special accommodations CPS requires a request in writing with your preferred location and exam date as well as your contact information. You must also attach a document signed by your clergy or doctor on their official letterhead specifically identifying the accommodation required. Send your official request to CPS, Attn. D. Wood, 241 Lathrop Way, Sacramento, CA 95815 or FAX (916) 561-7239.


LOGIN INFORMATION
Enter your desired CPS account information.
User Name: *
Password: * (Password Policy)
Retype Password: *
Password Recovery Question: *
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