SSN   (no dashes) Example: 123456789
Confirm SSN
First Name
Last Name
Middle Initial  (optional)
Birthdate  /   /  MM / DD / YYYY  Example: 08 10 1984
User Name  Between 6 and 16 characters long 
Password  Between 8 and 16 characters long (at least 1 number and 1 letter, case-sensitive)
Confirm Password
Security Question   Less than 40 characters
Security Answer  Less than 40 characters
Email Address  
Confirm Email    

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