IMPORTANT FORM UPDATE: Beginning June 1st, the administrator registration form below will no longer be available and all requests to update administrator privileges will need to be submitted within Technology Manager.

Refer to the Corporate and User Administrator job aids for assistance with this new process.

Note: User Administrators who are unable to access administrator privileges within Technology Manager must contact the Technology Support Center (800-232-6643) for assistance.

Important: Please provide a unique PIN for each new user. The PIN will be required during the password retrieval process. Each PIN must contain exactly four digits (numeric) and should not be easy for others to guess. Password retrieval instructions will be sent to the e-mail address designated on this form for each user.