Company Name is required
Contact Name is required
Invalid Email, proper format "name@something.com" Email is required
Phone is required
Street Address is required
City is required
State is required
Zip Code is required

Username is required
Password is required
Confirm Password is required

>> HINT: The password should be at least seven characters long. To make it stronger, use upper and lower case letters, numbers and symbols like ! " ? $ % ^ & ).
 
Terms/Conditions is required
 
Privacy Policy is required