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[jp_login_screen]

[jp_profile_picture]

Change Password

[jp_profile_changepassword]

[jp_profile_start_form]

Personal Information

Prefix
[jp_profile_dropdowns name=”prefix” dd_override=”prefix”]

First Name*
[jp_profile_field fieldtype=”text” name=”fname” required=”true”]

Middle Name
[jp_profile_field fieldtype=”text” name=”mname”]

Last Name*
[jp_profile_field fieldtype=”text” name=”lname” required=”true”]

Suffix
[jp_profile_dropdowns name=”suffix” dd_override=”suffix”]

Date of Birth*
[jp_profile_field name=”dob” fieldtype=”datepicker” required=”true”]

Degrees*
[jp_profile_dropdowns name=”desig” dd_override=”desig” multiple=”true” required=”true”]

Other Degree(s)*
[jp_profile_field fieldtype=”text” name=”desig_other” required=”true”]

Gender
[jp_profile_dropdowns name=”gender” dd_override=”gender”]

Race
[jp_profile_dropdowns name=”ethnicity” dd_override=”ethnicity”]

Contact Information

Address Type

Country*
[jp_profile_dropdowns name=”addresses,0,country” dd_override=”country” required=”true” onchange=”JPDropDown.countryChangeHandler($(‘#JoinForm’))”]

State*
[jp_profile_dropdowns name=”addresses,0,us_state” style=”display:block;” dd_override=”state” required=”true”][jp_profile_field fieldtype=”text” name=”addresses,0,state” style=”display:none;”]

City*
[jp_profile_field fieldtype=”text” name=”addresses,0,city” required=”true”]

Street Address Line 1*
[jp_profile_field fieldtype=”text” name=”addresses,0,add1″ required=”true”]

Street Address Line 2
[jp_profile_field fieldtype=”text” name=”addresses,0,add2″]

Zip*
[jp_profile_field fieldtype=”text” name=”addresses,0,zip” required=”true” required=”true”]

Phone*
[jp_profile_field fieldtype=”text” name=”addresses,0,phone” required=”true”]

Professional Details

Academic Title*

[jp_profile_field fieldtype=”text” name=”jtitle” required=”true”]

Institution’s Name*

[jp_profile_field fieldtype=”text” name=”company” required=”true”]

[jp_profile_field submit=”UPDATE PROFILE”]