First name
Last name
Alps name	* A name family or friends can use to find you on alpsstore
Date of birth:	year     month     day
Gender	Female Male
E-mail address
Phone number
City/Town
Street Address
Province	Central Copperbelt Eastern Luapula Lusaka Muchinga Northern North Western Southern Western
Country	* Currently only available in Zambia
Password	*Password should have more than 5 characters.
Confirm password