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Your E-Mail Address
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Choose a Login Name (User ID)

It must be 6 or more characters in length and may
only contain small letters, numbers, and
the underscore '_'		 check for uniqueness
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First Provider Name*
List Provider Name Here
First Provider Phone Number*
Please list the provider's telephone number.
First Provider Details*
Please provide any details that would allow the provider to recall your visit, such as time, style, location, gifts, tatoos, etc
Second Provider Name
More than one reference will speed up and increase your chances of membership approval. If you do not have one, leave this blank.
Second Provider Phone Number
Second Provider Details
Employer Name
Fill this out ONLY if you have no Provider Reference.. If you have a reference... skip all employer INFO requested.
Employer's Main Number
Employer's Website
Safe Telephone Number
Please enter a safe number that we can call you during normal business hours (8am - 5pm). This information will be deleted after your membership is cleared.
You can send a pymt via mail
You can also send in a payment via mail. P.O. Box 3753 Minneapolis, MN 55403 Be sure to include your name, email and phone
Money Orders/Checks
either are acceptable
Questions?
email admin@myfastpass.com If you are sending in a payment via mail, quit the process and send an email to admin. You are finished.
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