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Step
5: Complete the Registration Form and click Create Account.
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Complete the Registration
Form. Click the Create Account button.
You must
complete the fields marked with a red asterisk (*)
to proceed with your registration. The remaining fields are optional.
For information on each field of the registration form, scroll to the
section at the bottom of this help page titled, Understanding
the Registration Form.
Note: The email
address you fill in will be your User Name to access eAppoint. Please
fill in an email address that you have access to, as you will need access
to this email address to activate your account. |
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The Appointing Entity Registration Wizard: Page Five
(Registration Form) |
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Upon completion of the registration process, the last registration page
will display (see the page to the left). eAppoint will send an email to
the address you specified containing an activation code and web address
for account activation. You will not
be able to access your eAppoint account until the account is activated.
A letter will also be sent to the Invoicing address you specified, also
containing the activation code and web address for account activation.
If you do not receive this information, please contact the Bureau of Agent
and Agency Licensing. |
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The
Appointing Entity Registration Wizard: Page Six
(Successful Completion of Registration) |
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Congratulations! This
completes the process to register to become an appointing entity.
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Potential Errors That May
Occur in Step 4:
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If the email address you use to register the appointing entity has already
been used to register another appointing entity, the error message to
the left will display.
Each appointing entity must be associated with a unique email address. |
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Field Name |
Field Category |
Description |
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Appointing Entity Name |
Appointing Entity Details |
The name of the Appointing Entity. |
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Firm Name |
Appointing Entity Details |
The name of the Agency. |
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First Name |
Contact Person |
First name of the Contact Person. |
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Middle Initial |
Contact Person |
Middle initial of the Contact Person. |
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Last Name |
Contact Person |
Last name of the Contact Person. |
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E-Mail Address |
Contact Person |
Email address for the Contact Person. A valid
address must be entered for verification. |
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Your Title |
Contact Person |
Position title of the Contact Person. |
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Your Department |
Contact Person |
Department name of the Contact Person. |
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Password |
Contact Person |
Password provided by the user. |
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Re-Type Password |
Contact Person |
Re-type the password in the previous field. |
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Phone |
Contact Phone |
Phone number of the registering entity. |
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Phone Extension |
Contact Phone |
Extension of the registering entity. |
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Fax Number |
Contact Phone |
Fax number of the registering entity. |
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Street |
Invoicing Address |
Street number and name of the invoicing address
(where the Renewal Invoices should be mailed). |
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Optional Street |
Invoicing Address |
Optional second line of text for the street
information of the invoicing address. |
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City |
Invoicing Address |
City of the invoicing address. |
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State |
Invoicing Address |
State of the invoicing address. |
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Zip/Postal Code |
Invoicing Address |
Zip or Postal code of the invoicing address. |
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Country |
Invoicing Address |
County of the invoicing address. |
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Street |
Contact Address |
The contact person's street address. |
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Optional Street |
Contact Address |
Optional second line of text for the street
information of the contact person's address. |
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City |
Contact Address |
City of the contact person's
address. |
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State |
Contact Address |
State of the contact person's address. |
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Zip/Postal Code |
Contact Address |
Zip or Postal code of the contact person's
address. |
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Country |
Contact Address |
County of the contact person's address. |