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 Activate Your FREE Membership Today ... It's as Easy As 1-2-3!!!
 Welcome to the Hospital Newspaper Website Membership Registration Page. We are asking you to provide us with some very basic information to help us register you for your complimentary membership. Unlike other emergency services sites, all of the exciting content on the Hospital Newspaper Website is FREE OF CHARGE! The only thing we ask is that, as a minimum, you complete all of the txts labeled with an asterisk (* ) below. All members completing the entire Registration Form will automatically be entered into our periodic prize give-away. Thank you.
 Complete all of the texts with ( * ) below.
Step 1- Choose a User Name and Password and provide us with a valid e-mail address.
 * User name: (maximum 12 character)
Please note: The name you choose for your username will be your own unique identification on the Hospital Newspaper Website and will be the 'handle' that others on the website and in the forums will come to know you by.
  * Password:(minimum 4 maximum 8 character)   * Confirm Password: 
Step 2- Now we need some basic information about you
  * E-mail Address:   * Confirm E-mail Address:
  * First Name: M.I: * Last Name:
  Home Address 1:
  Home Address 2:
  * Home City : * State or Province:
  * Postal Code: * Country:
  * Home Phone:
  * Gender: * Year Of Birth: (e.g. 1980)
Step 3- Now we would like to know about your Department or Company
  * Employer/College: * Description:
  * Title/Job Description: Years of Experience:
  * Address 1:
  Address 2:
 * City:  * State or Province:
  * Postal Code:  * Country:
e.g. US / Canada Phone or fax number: (123-432-2345) Other (24-22-323-23342)
  * Phone Number:  Fax Number:
        [Sample Profile]
We will not display your street address or telephone numbers to the public. Once you are registered and you confirm your registration by responding from your valid email, you will be able to modify your public profile settings.
I have carefully read the Terms of Service and Privacy Policy and agree to them.
Please Click To Apply For Membership
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