First Name *

Last Name *

Gender * Select Gender Male Female

Registration Number *

Username *

Only letters, numbers, and underscore. No spaces.

Email Address *

Phone Number * Format: 0712345678 (10 digits starting with 06 or 07)

Password *

Confirm Password *

Student ID Card *

Click to upload Student ID Card

JPG, PNG, or PDF (Max 5MB)

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