Student

[ewf-iconbox title=”Student Membership” icon=”ifc-edit” style=”icon-box-01″ link=”#” align=”left”][/ewf-iconbox]

 

First Name (required)

Last Name (required)

Address (required)

City (required)

Province/Territory/State (required)

Country (required)

Home Phone (required)

Your Cell Phone (required)

Primary Email (required)

How do you hope to benefit from membership?

How did you learn about the NB2PW?

Program of study (required)

Date completed or expected date of completion (required)

Institution name

Are you working? (required)

If YES, provide name of current employer

Current position

NB2PW believes that the success of the Network is dependent upon the direct contribution of each and every one of our members. To that end, we strongly encourage all of our members to directly support the growth of the Network by participating in one of the following functions.

If other, please specify