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To successfully complete the registration form, please manually type your information in the fields below. Do not use copy/paste or autofill settings.
The text in the email, password, and confirm fields will turn green when successfully entered. If text appears in red or yellow, please re-type until it appears in green.
The new password must match the following requirements:
- password must contain at least 6 characters- password must contain mixed case- password must contain at least a symbol (.[!,@,#,$,%,^,&,*,?,_,~,-,(,)])- password must not match the user login name