New User Account

Prefix Example: Mr., Mrs., Dr., etc.

First Name *

Middle Name

Last Name *

Texas Unique ID (Optional)

PIN (4-digit number) *

Date of Birth *

Email *

Password *

Phone *

Do you want to receive text messages? *

Yes No

Notice and Acknowledgment

I acknowledge and understand Region 15 ESC is a governmental entity and that any information which I provide in this profile page is subject to the provisions of the Texas Public Information Act (Chapter 552 of the Texas Government Code).

I acknowledge and understand that I am required to provide an email address as part of my profile. I understand and agree that if I include in my profile a personal email address I am expressly waiving any confidentiality in my personal email address and consenting to Region 15 ESC disclosing it in response to any request made to Region 15 ESC for its disclosure under the Texas Public Information Act.

I acknowledge and understand that a personal email address is an email address other than an email address issued to me by a governmental body for my use as an employee of the governmental body.