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In order to reset your AlphaNet email address and password, we'll need your last name, the last four digits of your social security number, and your birthdate. Once you complete this form, your AlphaNet email address will be updated to match the email you provided, and your password will be updated as well.
Last Name: *
Last 4 Digits of Social Security Number: *
Date of Birth:
New E-Mail Address: *
New Password:
Confirm New Password: