COB Request for Information

*First Name

Preferred Name

*Last Name

*Date of Birth

*Email

*Confirm your email address

Email Comparison (HIDDEN)

Email addresses do not match.

By checking this box, I opt in to receive text messages from Sacramento State.

Yes

No

Opt-in Confirmation: You have opt-in to receive notifications from Sacramento State. Sacramento State May, directly or through third-parties acting on its behalf, send marketing information regarding Sacramento State and your continuing education, including texts, emails, and calls made using an automated dialing system to the number and email address that you provided above. Providing this consent is not required to obtain any good or service. Please refer to CSU Privacy Policy Statement for terms of use.

Mobile Phone Number
By providing phone number, you consent to receive calls or texts (if opted-in above) from Sacramento State. Reply STOP to unsubscribe. Msg & Data rates may apply. Please refer to CSU Privacy Policy Statement for terms of use.

*What major are you interested in studying?

*Which term would you be applying for?

What advertisement was used?

Advertisement - Other

Billboards

Radio

Television

What online source did you hear about us from?

Online - Other

Social Media

Web Search

Website/Program Site

Which event did you hear about us from?

Please tell us how you heard about us

Population_COB (Hidden field)

Student type (Hidden field)