User online registration

User Registration
Fill out the following page and we will process your registration. All fields are required to complete your registration. After registering, your account request will be validated against our TelCo database. You will receive notification when your online account has been approved.
Telephone Company Name:
Address:
City:
State/Province/Region:	or other:
Zip/Postal Code:
Phone Number:
Contact First Name:
Contact Last Name:
Contact Email Address:
This email will be used to identify you and send your username and password in the event you forget them. If you change your email address, please remember to update your user information. This will allow you to be able to obtain your username and password in the event you forget them.
Please select a username and password. This username will be used to gain access to the secure areas of the web site, which will allow you to submit information via online forms. Your password must be at least 4 characters long.
Username:
Password:
Re-Type Password:
If you are an Incumbent Local Exchange Carrier or a Competitive Local Exchange Carrier, you may receive support payments. If you anticipate requesting support payments, please provide the following account information to be used for electronic transfer of payments to you.
Bank Routing Number:
Account Number:

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