Create an Account

  • Name

  • This field can be seen by: EveryoneChange

  • This field can be seen by: EveryoneChange

  • List award they have received

    This field can be seen by: EveryoneChange

  • This field can be seen by: EveryoneChange

  • Contact Info

  • This field can be seen by: EveryoneChange

  • About Yourself

  • This field can be seen by: EveryoneChange

  • This field can be seen by: EveryoneChange

  • Password

    Enter any password. The user will need to create a new password the first time they access the website.
  • This field can be seen by: EveryoneChange

  • NIPTE Member Role

    This field can be seen by: EveryoneChange

  • This field can be seen by: EveryoneChange

  • Board committees

    This field can be seen by: EveryoneChange

  • Board committee role

    This field can be seen by: EveryoneChange

  • Role on FAC

    This field can be seen by: EveryoneChange

  • Faculty committees, focus groups and centers

    This field can be seen by: EveryoneChange

  • Use this field to select the committee if leadership role.

    This field can be seen by: EveryoneChange

  • Committee Leadership Role

    This field can be seen by: EveryoneChange

  • Assistant to the board or faculty member (First Name)

    This field can be seen by: EveryoneChange

  • Assistant to the board or faculty member (Last Name)

    This field can be seen by: EveryoneChange

  • Assistant to the board or faculty member (email)

    This field can be seen by: EveryoneChange

  • DEFAULT FIELDS

    These fields have default values that will normally be correct. However, if additional information is provided, update applicable fields. Otherwise, leave all below items as is.