User Registration Request Form

User Registration Request Form

In order to obtain access to the user section of the 15th Chancery Court District of Mississippi Web Site you must register with the Court Administrator. Complete the following information and press the submit button to register with the Administrator. If you have problems or questions you may email Bethany Lewis, Court Administrator with a description of the problem you encountered, your name, firm name and call back number. Please allow 24-48 hours for your account to become active.

Requested User Name: (preferably your email address or full name; example: johndoe@something.com or John Doe)
Requested Password: (suggested between 6 and 10 characters, numbers or combination thereof)
                Your Name: ,
                                                                   (last)                                            (first)
                        Your Firm:
Your Phone Number: (example: 601-555-1212)
   Your Email Address:

By pressing the submit button I certify that all information entered above is true and correct and that I have legitimate business with the Court and desire access to the User Area of the Web Site.