NW-SCC Nursing Alumni Application
First Name:
Last Name:
Mailing Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Cell Phone:
E-Mail Address:
Year of Graduation:
Birthdate (MM/DD/YYYY):
Login & Password will appear as astericks (*) as you type for security purposes.
What would you like your login to be?
What would you like your password to be?
Yes, I would like to be included in the online directory. The information above will be included in a secure directory where
all
alumni members may access it.
Yes, I would like to be included in the online directory. The information above will be included in a secure directory where other alumni members
in my graduating class
may access it.
No, I do not want to be included in the online directory.