MyImpactPage - Team Maryland

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Account

Username

Required

	Username must not start with space
	Username must not end with space
	Username must not have two or more spaces in a row

Password

Required

	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Confirm Password

Required

	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Name Fields

Salutation
Legal First Name
First Name Required
Middle Name
Last Name Required
Suffix
Pronouns

Address

Address line 1 Required
Address line 2
City Required
Country Required
State / Province Required
Zip / Postal Code Required

Email Addresses

Email Address Required
Secondary Email Address

Phone Numbers

Required Please enter at least one phone number

Home Phone
Work Phone
Work Extension
Cell Phone
Phone Preference

Online Presence

X Username @
Linkedin Profile URL
Instagram Username

Misc Fields

Region

Administration

Occupation

Required

Clothing Size

Required

Spose/Partner Name

Required

Transplant Information

Transplant Center

Required

Organ/Organs Received

Required

Transplant Date

mm/dd/yyyy Required

2nd Transplant Date

mm/dd/yyyy

3rd Transplant Date

mm/dd/yyyy

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