Username (this is kind of like a code name you will be using to login to your account instead of using your real name. The username can be anything you like as long as it is within 25 characters long, NOTHING vulgar, and it cannot contain ANY spaces or special characters (example: ! @ # $ % & *)

Password (a password is used so only you can login to your account. If someone has your username, they will not be able to login to your account without having your password. Choose something easy for you to remember and keep it in a safe place) The password can be anything you like as long as it is within 25 characters long, NOTHING vulgar, and it cannot contain ANY spaces or special characters (example: ! @ # $ % & *)

First Name   Last Name     Company name  

  Email Address 

Address    City   State   Zip Code 

Phone Number (include area code) 

mailing address if different from physical address

address     city     state     zip code

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