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Registration

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Using the information that's on your ID Card, please fill out the necessary fields below to complete your registration. Included in those necessary fields below, you are also able to create the User ID and Password you will use when logging into the Portal.

Criteria

Enter your Member ID number as it appears on your card.
User ID & Password - these values are case sensitive and must be at least 8 characters long.
Password cannot match your User ID.
Password must also contain a combination of at least 3 of these 4 items: Uppercase character(s), Lowercase character(s), Number(s), Special character(s).

ID Number :

Last Name :

First Name :

Relationship Code :

Gender :

Birth Date :

User ID :

Password :

Confirm Password :

Email Address * :

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