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Applicant Name
Applicant Name is required
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Password
5 to 10 letters or digits only
Password is required
Password must be 5 to 10 characters long
and can contain only letters or digits
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Confirm Password
Confirm Password is required
Password' and 'Confirm Password' must match
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Address
Address is required
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City
City is required
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State
State must be 2 letters
State is required
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Zip Code
Zip Code must be formatted correctly.
Examples: '12345' or '12345-1234'
Zip Code is required
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Phone
Example: 650-123-4567
Phone must be formatted correctly.
Examples: '650-123-4567' or '650-111-2222 x1234'
Phone is required
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Email
Email must be formatted correctly.
Example: 'jane@do.com'
Email is required
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Applicant Type
Owner or Builder
Contractor
If you are a contractor, the next 5 fields below are required
Company Name
Contractor License #
Contractor License Class
Workers' Comp. Carrier
Workers' Comp. Policy #
Optional Credit Card Billing Information
Cardholder's Name
Address
City
State
State must be 2 letters
Zip Code
Zip Code must be 5 digits
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