Create Account

Enter your account information. All fields are required.

Please use your REAL NAME when setting up your account. NO NICKNAMES or abbreviations! The name you enter will be the only name printed on the certificate and can not be changed. The name and birth date entered must match your records in other applications to verify certification.

Your username can contain letters or numbers and must be between 6 and 32 characters.

A password must be eight characters or longer, contain at least one number, and contain either a capital letter or a special character.

Check all the races that apply to you. If your ethnicity is "Non-Hispanic", you must select at least one option.