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| Email Address __________________________________________________ | ||
| Full Name ______________________________________________________ | ||
| Address: _______________________________________________________ | ||
| City: ___________________________________________________________ | ||
| State: __________________________________________________________ | ||
| Zip: ____________________________ | Phone: ( ____ ) _____ - _________ | |
| Country: _______________________________________________________ | ||
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All
usernames and passwords must be in lowercase, and have a minimum of 4 letters and 2 numbers.
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| Prefered
Username 1) ___________________ 2) _____________________ Enter two choices in case one is taken. |
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| Prefered
Password 1) ___________________
2) _____________________ Enter two choices in case one is taken. |
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We
will email you when your account is activated.
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| Your payment MUST be made in US FUNDS ONLY! | ||
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