Independent User Registration

Independent User Registration

To apply for an independent user ID, fill out the form below, and click Send Application when you are through. If you have already been assigned a user ID, you will be prompted to convert that ID to an Independent user ID. If you have not been assigned a user ID yet, an ID will be assigned and mailed to you. The password will not be disclosed, so make sure you remember it!!!

And remember:
Warning! Misuse of Federal Information at this Web site falls under the provisions of Title 18, United States Code, section 1030. This law specifies penalties for exceeding authorized access, alteration, damage or destruction of information residing on Federal Computers.

First Name:
Middle Initial:
Last Name:
Social Security Number:

Provide your e-mail address.

Include your e-mail user name, the @ sign and [servicename.com/edu/org/net/etc.]. For example: jsmith@aol.com, johndoe@adv.org, hfdb84a@prodigy.com.

E-mail Address:

Choose a Password.

You will enter your password each time you use this service. Your password should be 6 characters in length and should be comprised of letters and numbers (for example, Brad83). Do not use punctuation or special characters. Important: Your password will be recorded EXACTLY as you type it, so make a note if you enter in upper and lower case.

Password:
Re-enter Password for Verification:

Mother's Maiden Name.

Please provide this information for future verification when processing password reset requests.

Mother's Maiden Name:

Content updated January 6, 2018

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