British Corner Shop - New User Registration

New User Registration
Your Details	*Required*	*Enter your Details*
First Name
Surname
E-mail Address
Phone
Address (without postcode)		(comma separated)
Postcode		(Important - enter your postal code separately here)
Country (for order delivery)		(Select your Country)
Feedback
Where did you hear about us?
Create your Unique Login		Use lower case letters and numbers only:
Username		(up to 12 characters)
Password		(up to 12 characters)