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Contact us: continuinged@nwhealth.edu or 952-885-5446 (Mon-Fri 9am-4pm)

Add Attendee

Please provide the following personal information. Use your full legal name. This is how it will appear on your official record. Important note: A unique email address is REQUIRED for every attendee.
Items marked with a * are required.

Full Legal First Name *

Full Legal Last Name *

Date of Birth (mm/dd/yyyy) *

When did you graduate from Northwestern? If no, enter 0. *

Address *

Address Line 2

City *

State/Province *

Zip/Postal Code *

Country *

Daytime Phone *

Email Address *

Please send me information about upcoming CE events (yes/no) *

Professional Type *

Chiropractor License(s)

Acupuncture License(s)

Massage License(s)

If applicable, please provide the following company information

skip this if you are not affiliated with a Company

Company Name *

Address *

Address Line 2 *

City *

State *

Zip/Postal Code *

Country *

Phone *