CEU Enrollment

CEU Enrollment Form

Course Code

Description

New Student Yes No

Name

Previous Name(s)

Date of Birth

Student ID or SSN

New Address Yes No

Address

City

State

ZIP Code

Phone

US Citizen Yes No Prefer not to answer

Gender Male Female Other/Prefer not to answer

Initials

Your initials authorize Northwest Indian College to use this form to enroll you in this Continuing Education course and obtain tribal enrollment verification, if applicable.

NOTE: Northwest Indian College is approved by the Office of Superintendent of Public Instruction to offer clock hours. Clock hours can be attained by emailing CooperativeExtension@nwic.edu. Students may request their official transcripts by contacting EnrollmentServices@nwic.edu.