Create a new WEBT Online Portal User
We have found your member record under multiple employers. Please select the employer you would like to create an account for:
Employee Information
First Name
Last Name *
Required
Date of Birth *
Required
Last 4 SSN*
Required
Email *
Email Address should be in proper Format
Required
Username *
Required to be in format of email address
Username should be in proper Format
Required
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Create