Membership Request

Please provide the information requested below.

Upon receipt of your membership request, NUCPS staff will attempt to verify your participation in a past NUCPS course/program. Once participation has been verified, NUCPS will contact you via e-mail with further instructions for setting up your membership account.

If you already have an account, please sign in now.
* First Name:
* Last Name:
* E-mail Address:
* Mailing Address:  
* City, State, Zip     
* Phone Number:  
* Class Attended  
* Class Year   
* Class Location   
* Required Field