USERNAMEPASSWORD

Create Your CHPS.net Account

Create Your CHPS.net Account



YOUR INFORMATION

First Name *
Last Name *
Address
City
State *
Zip Code
Telephone
Organization Name
Job Title
 
YOUR CHPS.NET ACCOUNT
Username*
Email***


IF YOU ARE AN EMPLOYEE OF A CHPS MEMBER ORGANIZATION
Enter CHPS.net account of your organization
Enter email address of organization account



* This is a required field.
** Please enter a valid e-mail address. You will be sent a temporary password and a link to log-in. On your intial login we recommend you change your password by clicking on the My Account link on the left navigation menu. All e-mails from the website administrator will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by email.

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