Create an Account Account Details Username (required)Email Address (required) Choose a Password (required) Strength indicator Confirm use of weak password Confirm new password Hint: The password should be at least twelve characters long. To make it stronger, use upper and lower case letters, numbers, and symbols like ! " ? $ % ^ & ). Referrer Code (optional) Age Confirmation (required) I am at least 18 years old. Profile Details Handle (required) This is your handle on The International Quit & Recovery Registry. All your actions on the site are identified with your handle. It is different from your user name and can be changed while your user name can not. We do not recommend using your real name for your handle or username. This field may be seen by: Everyone Date of birth (required) This will be used for validation of data provided for our research. Day ----12345678910111213141516171819202122232425262728293031 Month ----JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year ----2020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900 This field may be seen by: Only Me Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close Have you checked the age confirmation box on the left side? (required) Just double-checking. You must be 18+ before you can register. Yes, I have checked. This field may be seen by: Everyone Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close What is your country of origin? (required) This will be used for validation of data provided for our research. This field may be seen by: Only Me Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close In which country do you live? (required) This will be used for validation of data provided for our research. This field may be seen by: Only Me Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close What is your sex at birth? (required) ----FemaleMaleOther This will be used for validation of data provided for our research. This field may be seen by: Only Me Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close Location This address will be used on the members directory map, please make sure the address is valid for Google Map This field may be seen by: Only Me Change Who is allowed to see this field? Everyone Only Me All Members My Friends Close Only 1 Account Per Person, Please.
