Register - My Benefit Choices

*User Name:

Username must be at least 8 characters long.

*Password:

The password length must be between 8 and 50 characters and must contain at least 1 lower case letter, 1 upper case letter, 1 number, and 1 special character. There must be no spaces.

# of Characters
Number
Lower Case Letter
Upper Case Letter
Special Character
No Invalid Characters

*Confirm Password:

*E-mail:

Make sure to whitelist Local18@mybenefitchoices.com

*Confirm E-mail:

*Security Question:

*Security Answer:

I Agree to the Following:

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