New User Registration

User ID *  6-15 characters (no special characters such as $,#,@,&,=,! or spaces)
Password *  8-20 characters with at least 1 digit, 1 lower case and 1 upper case character
Retype Password *
Secret question *
Secret answer *
FirstName *
LastName *
Middle Name  
Birth Date *   mm/dd/yyyy
Bar Number  
Email *
Retype Email *
Address *
Apt  
City *
State *
ZipCode *
Phone Primary *
Phone Alternate1  
Phone Alternate2  
*Required fields