It appears fine to me. If you can't get through I suggest using a different internet browser or signing out/in again to your bungie.net account.
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I've tried on chrome and IE, as well as on my android browser. I can fill out all the other parts of the form with no issues, but the email text box doesn't seem to want to accept any input. I'm not too worried about it because I was able to submit the application while signed in to this account, which is tied to my primary email. Just curious if anyone else was running into the same issue. I think I may have signed up for this a while back anyway, but I saw a new message about it this morning and figured it couldn't hurt to sign up again.
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After you submit for the first time, you don't need to do it again, but it doesn't hurt to update your information. When you click through it again, it doesn't display your answers from the previous time, it's suppose to be blank. The Webteam mentioned that they're fixing this so you can see your previous entries. I believe by default the email entry to inputs your primary email of the account you're using, it's locked in a sense.
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Cool, that makes sense. Thanks for the heads up