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Phone Number

Must be exactly 11 digits

First Name

Last Name

Date of Birth

Gender

Region

Province

Municipality

Barangay

House No. & Street Name

Username

Password

At least 8 characters long

At least one uppercase letter (A-Z)

At least one lowercase letter (a-z)

At least one number (0-9)

At least one special character (! " # $ % & ' ( ) * + , - . / : ; < = > ? @ [ \ ] ^ _ ` { | } ~)