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Native Health Professions Day Registration Form

Register here to attend Native Health Professions Day on Wednesday, June 16th from 10am-3pm. Open to American Indian, Alaskan Native and Native Hawaiian high school and community college students interested in pursuing a health career. 

Registration closes Friday, June 11th at 11:59pm. 

All activities will be done virtually. You will receive the zoom link to join the event the day before via email.  
1.First Name(Required.)
2.Last Name(Required.)
3.Email Address(Required.)
4.Phone Number(Required.)
5.High School or Community College currently attending(Required.)
6.Grade(Required.)
7.Mailing address(Required.)
8.Tribal affiliation
9.Gender(Required.)
10.Ethnicity(Required.)
11.Race(Required.)
12.Are you interested in attending college? If so, which one(s)?(Required.)
13.Which health careers are you currently interested in? (Required.)
14.Are you the first in your family to pursue a career in health?(Required.)