Membership Application

First Name*

Last Name*

Tribal Affiliation (if applicable)

Title

Organization

Email*

Member Profile

The following questions will be used to set up your NEPN Member Profile.

Profile Name*

Your profile name is what others view when they visit your page. It can be your real name, a nickname, or anything else you choose.

User Name*

Your User Name is a unique identifier that allows users to find and mention you on the portal. Do no use spaces or special symbols. For example, Joe Smith’s User Name could be jsmith. User Names cannot be changed.

Which is your area of interest – Other

Which of the following best describes your current status – Other

About You

To help us get to know you better and ensure the Network is offering services and programs that are most helpful to you, below are a few questions for your consideration. Answering the following questions is voluntary, but we ask that you provide as much information as you can.

What challenges have you or your colleagues encountered while working to achieve your career goals?

If you are an emerging professional, what resources or support do you need to advance in your career? If you are a seasoned professional, what resources or support are/were most helpful to you as you advanced in your career?

What skills or knowledge areas do you believe are essential for success in your field?

The Network plans to offer monthly online gatherings that include training, announcements, and other helpful information. Are there training topics you would like to see offered?

Do you currently participate in any professional development networks that you find beneficial? Your response to this question will contribute to a list of available resources.

Have you had access to mentors or role models in your field? If yes, how valuable has this been to your professional growth?

Do you have any words of wisdom or keys to success that you would like to share?

One Paragraph Bio

We are so happy you are joining the Network! Is there anything else you would like to share with us?

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