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Customer Registration
First Name
First Name is required!
Last Name
Last Name is required!
Email address
Email is required!
Phone Number
Phone is required!
Region
Select Region
Dar es Salaam
Dodoma
Arusha
Mwanza
Mbeya
Region is required!
Gender (*)
Select Gender
Male
Female
Gender is required!
Password
Password is required!
Confirm Password
Confirm Password is required!
Complete
