Registration

Create Researcher Account


The registration process consists of three steps:
  • Creation of your account
  • Approval by Site Moderator
  • Logging in and completing your clinical capabilities
After creating your account and receiving approval confirmation, you must log in to complete the registration process.

All fields are required.

Personal Info
First Name:
* This Field is required Information for: Your First Name : Your first name, or the primary contact for the registrant.  If you are a parent registering a child, this is your name, NOT your child's name.
Last Name:
* This Field is required
Title:
* This Field is required
Organization:
* This Field is required
Institution:
* This Field is required
Contact
Phone:
Email:
* This Field is required Information for: Email : Please enter a valid e-mail address. A confirmation email will be sent to this address upon registration.
Address:
City:
State:
Province (if outside USA):
Information for: Province (if not USA) : <p>
	For non-USA addresses</p>
Zip/postal Code:
* This Field is required
Country
* This Field is required

Account
Access Purpose:
* This Field is required Information for: Access Purpose : Enter a brief explanation of your reason for accessing the registry data.
Username:
* This Field is required Information for: Username : Please enter a valid username.  No spaces, at least 3 characters and contain 0-9,a-z,A-Z
Password:
* This Field is required Information for: Password : Please enter a valid password.  No spaces, at least 6 characters and contain lower and upper-case letters, numbers and special signs * This Field is required Information for: Verify Password : Please enter a valid password.  No spaces, at least 6 characters and contain lower and upper-case letters, numbers and special signs
* This Field is required
I agree to the terms and conditions

 
* This Field is required Required field | Information for: ? : Field description: Move mouse over icon Information: Point mouse to icon