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Agency Registration
Welcome to ShiftWise!
Please fill out the form below to register your agency. All fields marked with an asterisk (*) are required.
Account Information
Username
*
Required. 150 characters or fewer. Letters, digits and @/./+/-/_ only.
Email
*
This email will be used for account login and personal notifications.
Use same email for account and agency
Check this box to use your personal email for both your account and agency business communications.
Password
Your password can’t be too similar to your other personal information.
Your password must contain at least 12 characters.
Your password can’t be a commonly used password.
Your password can’t be entirely numeric.
Password confirmation
Enter the same password as before, for verification.
First name
*
Last name
*
Agency Information
Agency name
*
Agency type
*
Staffing
Healthcare
Training
Education
Other
Agency email
*
This email will be used for business communications and client-facing correspondence.
Agency phone number
Agency website
Agency Address
Address line1
*
Address line2
City
*
County
Postcode
*
Country
Register Agency
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