Username

Email

Confirm Email

Alternate Email

(Optional account recovery email)

Confirm Alternate Email

Mobile Phone

(Optional account recovery phone number)

First Name

Last Name

Previous Last Name(s)

(Optional - separate multiple names with commas)

Password

Confirm Password

Password Requirements

Contains at least seven non-blank characters
Contains at least three of the four following character sets:
- Lower-case letter
- Upper-case letter
- Number
- Special Character
Cannot contain angle brackets ('<' or '>')
Password and Password Confirmation fields match

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