NMSU-A Continuing Education Summer 2020 Course Registration
Please complete one registration per person.
Email *
First Name: *
Last Name: *
Phone number with area code: *
Mailing Address: *
City: *
State: *
Zip Code *
Age band: *
Gender *
Your level of education: *
Your ethnicity: *
Which Course do you wish to register for? (All Summer 2020 courses are Virtual!) *
Required
How would you like to pay for your course? (Sorry, no cash option.) *
Are you under 18 years of age? *
Parent/Guardian Name:
Parent/Guardian Email:
Parent/Guardian Phone (include area code):
Do you agree to these statements? WAIVER: I hereby agree and promise that I will not hold the Regents of New Mexico State University, their employees, their agents, or others who are involved in supervision or operations of activities sponsored by Continuing Education responsible for any damages and/or personal injuries which I may receive as a result of participation in Continuing Education courses. MEDIA WAIVER: I hereby grant to the Board of Regents of New Mexico State University, its employees, agents and assignees, the right to use photographs, video and/or digital recordings of me and materials created by me. HEALTH WAIVER: I attest to the fact that I have medical clearance to engage in the activities in the courses listed above. *
I am taking this course for the following reason:
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A copy of your responses will be emailed to the address you provided.
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