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* 1. What is your name?

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* 2. What is your x-number? (if you haven't received one yet that is okay)

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* 3. Who initiated you (e.g., who sent you this link?)

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* 4. What would you like your Element username to be? (Note: must be all lowercase)

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* 5. Please enter the email you would like us to send your login credentials to

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