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Registration
User Name
(User names can only contain letters, numbers and underscores)
Password
(Passwords must be at least eight characters long.
Your password must contain at least:
1. one lowercase letter;
2. one uppercase letter;
3. one number;
4. one symbol @=#!%&^+-$)
First Name
Last Name
User type
Agent
Agency Supervisor
Insurance Co. User
Agency or Insurance Co.
Address Line 1
Address Line 2
City
Province
Postal Code
E-mail
Phone Number
Alt Number
Cellular Number
Fax Number
Please Indicate the City and Province Where the Volume of Your Business is Conducted
Additional Information / Comments
I consent to the use of my email address for communications related to my account, including for messages that may be sent automatically from the Dynacare system, in accordance with Canada's Anti-Spam Legislation (CASL).