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Association Members
 
  Constituency Setup

[FrontPage Save Results Component]


To add a New Member to your Constituency database, fill-in  the
information fields below and click "Save New Member." The fields
marked * are required fields.    HELP

         Add a New Member                   

* First Name:
* Last Name:
* User Name:
* Please Enter User
Password:
* Please Re-enter User
Password:
* Address:
* City:   
* State: 
* Zip Code:
Phone: (Home)
Phone: (Work)
Email Address:
Date of Birth:
(mm/dd/yyyy)

If user forgets their password, please enter a question that we can ask to confirm user:
Enter Answer to question:

SaveNew_member.gif (354 bytes)Clear.gif (176 bytes)
<!! DEMO NOTE !!>
If your Group has added additional questions, the response would be the following  - click here