COE - AIITEC Registration

* denotes required field

First Name *

Last Name *

Affiliation *

Tribe *

Address 1 *

Address 2

City *

Country *

State

Postal Code

Work Phone Number *

Home Phone Number *

Email *

Fax Number

Payment Method *

PO Number *

Special Accommodation or Access Requests

Yes

Please describe requests *

Will you also be registering for the Indigenous Language Revitalization Summer Institute(ILRSI)? *

AIITEC Coordinator
Northern Arizona University
College of Education
P.O. Box 5774
Flagstaff, AZ 86011-5774, USA

aiitec@nau.edu

* Make checks and money orders payable to Northern Arizona University.

Dr. Louise Lockard
Phone 928-523-8218
Fax 928-523-1929
Louise.Lockard@nau.edu

Joe Martin, AIITEC Coordinator
Telephone: 928 523-5933
FAX: 928 523-1929
e-mail: Joseph.Martin@nau.edu

Registration is non-refundable.

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