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Agency & Principal
Registration
Agency Name
The agency name field is required.
Address
The address field is required.
Principal Name
The principal field is required.
Principal Surname
The principal field is required.
Principal Cellphone
The cellphone field is required.
Principal Email
The Principal email field is required.
Agency Telephone
Agency Email
The office email field is required.
Agency Website
Password
The password field is required.
Passwords must be 8 - 16 characters long & contain a minimum of 1 lower, 1 upper, 1 numeric & 1 special character.
Confirm password
The confirm password field is required.
The passwords do not match.