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* Candidate Username

Enter your Candidate Username, which is created by using your 6-digit birthdate and the last 4-digits of your SSN. For example: If your DOB is 12/01/1970 and your SSN is: 555121234, your username would be: 1201701234.

* Password

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* Candidate Username

* Email Address

* Repeat Email Address

* Password

* Repeat Password

* First Name

* Last Name

* Middle Initial

This should be a single letter ONLY. If you do not have a middle initial, please enter a period in this field.

Last Year of School

Native Language

Ethnicity

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Industry Segment

* Street Address

If applicable, please include your Apartment or Unit Number.

* City

* State

* Zip Code

* Country

* Phone Number

* Date of Birth

Gender

Employer Address

Employer City

Employer State

Employer Zip Code

Employee Number

Store Number

* Employer Name

* Exam Candidates Proctor Number

Payment Information

* Billing Method

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Pre-Paid Code Order Review

Code Course Package	#	Price	Total
	{{item.NumOrdered}}	{{item.Price.toLocaleString("en-US", { style: "currency", currency: "USD" })}}	{{(item.Price * item.NumOrdered).toLocaleString("en-US", { style: "currency", currency: "USD" })}}
	Total:	{{TotalToBeCharged.toLocaleString("en-US", { style: "currency", currency: "USD" })}}