Those with a star* are mandatory:

Note about Login Names:  You may enter a preferred username that must be made up of letters, numbers or the following three characters ._@.  If you leave the Login Name blank you will default to using your email address.  Please note that these names need to be unique, so we can't guarentee that you will be allowed to use the Login Name of your choice.  To increase the chance of been able to use the name of your choice include numbers and/or your last name.  First names will probably not be available.

Email opt out:
From time to time, OptionEasy may notify you either by post, telephone, email, or another form of communication, about products and services from OptionEasy that may be of interest to you.  The details you provide us will be treated in strict confidence and will not be released to 3rd parties.
If you do not wish to receive information from OptionEasy please tick this box

Supplier opt out:
From time to time, OptionEasy may notify you either by post, telephone, email, or another form of communication, about products and services from other 3rd party suppliers that may be of interest to you.  The details you provide us will be treated in strict confidence and will not be released to 3rd parties.
If you do not wish to receive information from OptionEasy please tick this box