User Registration
First Name
Surname
Username
Email Address
(Note: enter a valid email)
Password
Confirm Password
Phone Number
Format: 1234567890 (10-15 digits)
Date of Birth
Role
-- Select Role --
Student
Sales Rep
Agent
Admin
Profile Image
(Max 2MB, JPG/PNG format)
Referred By (if available)
City
State/Province
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