New User Registration

username +

email +

password + (at least 8 alphanumeric characters)

password + (repeat)

registration number -

name +

surname +

date of birth - [yyyy-mm-dd]

place of birth -

social security number -

groups -

I agree to terms and agreements

This form allows you to create a new user account.

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INSTITUT TEKNOLOGI KALIMANTAN - UPT Bahasa