Registration

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Register User v20170120

Actions

Step1: User Type

Step2: User Info

Step3: Confirm Account

Please complete the form below to register for the AVIP Portal.

Personal Information (* marks required fields)

*First Name	*Last Name	Middle Name

*Email Address	*Organization	*Department

*Re-enter Email Address
Re-enter email address can not be pasted. Please manually key in.

*Business Phone Number	Ext	Secondary Phone Number	Fax Number

###-###-####		###-###-####	###-###-####

*Enter the verification code characters shown
on the right (letters are not case sensitive)

If you can't see the characters clearly, click 'Change the characters above' button to regenerate the image.

When you have filled in the required information, please click on the Next button to continue.

Select User Type

User Info Creation

Confirm Account

Portlet Content