CEU Registration Form

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Please register. More information on CEUs can be found here: https://www.nwic.edu/wp-content/uploads/2019/05/CEU_BROCH_MAY2019.pdf

Email *

Name *

Address *

Phone Number *

Student ID/SSN

Ethic Origin *

Native American

Alaskan Native

Canadian First Nation

Hispanic of any race

Asian

Race Unknown

Native Hawaiian/Pacific Islander

Black/African American

White/Caucasian

Non-Resident Alien

Required

Tribal Affiliation *

Campus/Site Location *

Lummi Campus

Muckleshoot

Nez Perce

Nisqually

Port Gamble

Swinomish

Tulalip

Other:

Required

Quarter

Fall

Winter

Spring

Summer

Dept & Course *

By submitting and signing this form, you acknowledge that you are receiving a Northwest Indian College CEU. By checking the box you are indicating that the information provided is true and accurate, to the best of your knowledge. Please remember to fill out the evaluation after you have completed the 2020 Symposium. *

I acknowledge the above

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A copy of your responses will be emailed to the address you provided.

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