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Please complete the form below, all fields marked with a "*" are required information. After completing this form, you will have the opportunity to register with specific services upon receiving an email stating that your eUser has been approved and is ready to use. Approvals are sent by email Monday through Thursday, except Holidays.
First NameLast Name*
Name
Note: If you are registering as an individual, enter your first and last name. If you are registering as a business, enter the business name as last name and leave first name blank.
Address Line 1*
Address Line 2/Suite
City/State/Zip Code*
Phone Number* example: (209) 555-1212 or (209) 555-1212 3333
Email Address*
Select a Username*
Note: Usernames must be unique in our system, you will receive an error message if the username you have entered already exists in our database.

Your password must be between 8 and 16 characters long and consist of letters, numbers and at least on special character.
Select a Password*
Repeat Password*