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License Type * :

	Product	No of Login
	{{item.Title}}

Total Login : {{license.TotalLogins}}

Total Renewals : {{license.TotalRenewals}}

Renew

Account No * :

Account number is required

Edition * :

Product Key :

Licensee First Name * :

Licensee first name is required

Licensee Last Name * :

Licensee last name is required

Account Type * :

Institution Name * :

Institution name is required

Address * :

Address is required

City * :

City is required

State (only U.S.) * :

Country * :

Zip * :

Zip is required

Phone * :

(xxx-xxx-xxxx)

Phone is required

Phone is invalid

Email ID * :

Email is required

Email is invalid

Subscription Start Date*:

(mm/dd/yyyy)

Subscription start date is required

Subscription start date requires date in mm/dd/yyyy format

Subscription End Date*:

(mm/dd/yyyy)

Subscription end date is required

Subscription end date requires date in mm/dd/yyyy format

Renew Date * :

(mm/dd/yyyy)

Subscription renew date is required

Subscription renew date requires date in mm/dd/yyyy format

Subscription Price * :

Subscription price is required

Subscription price must be numeric

No. of Export Images * :

Number of export images is required

Number of export images must be numeric

Master Site URL * :

Site URL (From) :

Site URL (To) :

User Name * :

(Minimum 8 characters)

User Name of minimum 8 characters is required.

Password * :

(Minimum 8 characters)

Password of minimum 8 characters is required.

Security Question * :

Answer * :

Answer is required

Status :

Active Inactive

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