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Live AirMed WordPress Direct Delivery Plugin Demo Site
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Live AirMed WordPress Direct Delivery Plugin Demo Site
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* fields are required
First Name
Last Name
Company
Phone
Email
The email address you specify in this field will also be used as your username to login to the website. We suggest a corporate email.
Password
Password must be a minimum of 8 characters long and a maximum of 100.
Password must contain at least one character that is not a letter or number (eg. &, ^, *, -, _, %, #, $ ).
Password must contain at least one digit (0-9).
Password must contain at least one lowercase letter. (eg. a, b, c)
Password must contain at least one uppercase letter. (eg. A, B, C)
The password has invalid requirements
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Address Details
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Floor
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Address 2
Address 3
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Postal Code
License Details
Retail License No
PST Number
License File
*You must upload a valid, unexpired licence. Please do not upload Business Licenses or renewal notices, as this will create a delay in approving your account.
Payment Details
Payment Method
Upon province selection
Credit Card
E-Transfer Request
Pre-Authorized Debit (PAD)
Billing Email
*Billing email is used for payment requests. If not filled, your account email will be used instead.
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