New User

Please complete the form below, all fields marked with a "*" are required information.

First Name

Last Name*

Name

Note:

If you are registering as an individual, enter your first and last name. If you are registering as a business, enter the business name as last name and leave first name blank.

Address Line 1*

Address Line 2/Suite

City/State/Zip Code*

Phone Number*

example: (209) 555-1212 or (209) 555-1212 3333

Email Address*

Select a Username*

Note: If you do not have a personal e-mail address, contact the Helpdesk at (941) 743-1450 to request a County e-mail address.

Usernames must be unique in our system. You will receive an error message if the username you have entered already exists in our database.

Your password must be between 4 and 16 characters long and consist of letters and numbers only.

Select a Password*

Repeat Password*