Register

First name *

Midle name

Last name *

Referred by Member

Phone number *

Email address *

Password *

Confirm password *

Gender *

Date of birth *

Passport

State ID

State ID No *

Passport No*

Expire date *

Upload ID/DL/Passport Change Remove

State *

City *

Address *

Zip Code *

I agree to the terms and conditions

Item	Cost	Charges	Total
Registration Fee	$200.00	$8.00	$208
Total			$208

NB: Paypal charges are approximately $8.00 per $200.00 charge!