1. First Name
   Add your first name (required)
2. Last Name
   Add your last name (required)
3. Phone
   (e.g 269 000 0000)(required)
4. Email
   Enter your email address(required)
5. Email Confirm
   Re-enter your email address(required)
6. Customer Account Number
   Enter your customer number (optional)
7. Password
   Enter a password (required)
8. Shipping Address
   Enter your shipping address
9. City
   Enter the shipping city.
10. Zip Code
    Enter the shipping zipcode

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