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Cocoa Village Publishing
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https://cocoavillagepublishing.com
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Username
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E-mail address
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A valid e-mail address. All e-mails from the system 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 e-mail.
Personal Information
First Name
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Last Name
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Phone
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Biz/Org Name
Business or Organization Name, if appropriate. The content of this field is kept private and will not be shown publicly.
Address Line 1
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Physical address for communication and invoicing, address line1 The content of this field is kept private and will not be shown publicly.
Address Line 2
Physical address for communication and invoicing, address line1 The content of this field is kept private and will not be shown publicly.
City
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Physical address for communication and invoicing, city The content of this field is kept private and will not be shown publicly.
State
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Physical address for communication and invoicing, state The content of this field is kept private and will not be shown publicly.
Zip/Postal Code
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Physical address for communication and invoicing, zip/postal code The content of this field is kept private and will not be shown publicly.
Country
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Comments/Notes
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Comments/Notes about account., Please explain why you are requesting an account, else your request may be considered an automated attempt to spam. The content of this field is kept private and will not be shown publicly.
fax
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Relevant Website Address
If you have a website relevant to your account, please enter full address with http (url). For example your company's website for business, our your bio. The content of this field is kept private and will not be shown publicly.
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https://cocoavillagepublishing.com/user/register