New Member Account Registration Form

Instructions

This form is for members of Johnston County Building Industry Association to create a new User Account only.

Once a member has completed the form below and clicked on the REGISTER button, the form will generate an email to the email address provided.  You must click on the link in the email to validate your email address to activate your user account. Once you have done so, do not use this form again. Additionally, the link will work once only.  Do not try to log in here after creating your user account.  To log in, you should log in on the Home Page with the username and password you set when they created your User Account.  Once logged in, you can submit an entry for your member page, or edit an entry you may have submitted previously at the Member Directory.

Please enter the name!

Please provide an username!

Please provide a valid e-mail!

Retype the e-mail!

Please enter a password!

Retype the password!

Invalid Input

Complete the puzzle before submitting your form

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