Protection of Minors SafeColleges Training Request - Title IX and Equity

Read Before You Register

All University employees, including student employees, who work with minors must first complete the Supplemental Employment Form.

Download supplemental employment form

Camp/Organization Leader

First & Last Name:

919#:

Northwest Email: (format is username or s#@cqy114.com)

Camp/Organization Name:

Date of First Event:

Do you need to complete the training module? Yes No

Additional Participants

Number of Additional Participants:

Please list Northwest email (format is username or s#@cqy114.com) or personal email if none exists

Participant #1

First & Last Name:

919#:

Email:

Participant #2

First & Last Name:

919#:

Email:

Participant #3

First & Last Name:

919#:

Email:

Participant #4

First & Last Name:

919#:

Email:

Participant #5

First & Last Name:

919#:

Email:

Participant #6

First & Last Name:

919#:

Email:

Participant #7

First & Last Name:

919#:

Email:

Participant #8

First & Last Name:

919#:

Email:

Participant #9

First & Last Name:

919#:

Email:

Participant #10

First & Last Name:

919#:

Email:

Participant #11

First & Last Name:

919#:

Email:

Participant #12

First & Last Name:

919#:

Email:

Participant #13

First & Last Name:

919#:

Email:

Participant #14

First & Last Name:

919#:

Email:

Participant #15

First & Last Name:

919#:

Email:

Participant #16

First & Last Name:

919#:

Email:

Participant #17

First & Last Name:

919#:

Email:

Participant #18

First & Last Name:

919#:

Email:

Participant #19

First & Last Name:

919#:

Email:

Participant #20

First & Last Name:

919#:

Email:

Participant #21

First & Last Name:

919#:

Email:

Participant #22

First & Last Name:

919#:

Email:

Participant #23

First & Last Name:

919#:

Email:

Participant #24

First & Last Name:

919#:

Email:

Participant #25

First & Last Name:

919#:

Email:

Participant #26

First & Last Name:

919#:

Email:

Participant #27

First & Last Name:

919#:

Email:

Participant #28

First & Last Name:

919#:

Email:

Participant #29

First & Last Name:

919#:

Email:

Participant #30

First & Last Name:

919#:

Email:

Participant #31

First & Last Name:

919#:

Email:

Participant #32

First & Last Name:

919#:

Email:

Participant #33

First & Last Name:

919#:

Email:

Participant #34

First & Last Name:

919#:

Email:

Participant #35

First & Last Name:

919#:

Email:

Participant #36

First & Last Name:

919#:

Email:

Participant #37

First & Last Name:

919#:

Email:

Participant #38

First & Last Name:

919#:

Email:

Participant #39

First & Last Name:

919#:

Email:

Participant #40

First & Last Name:

919#:

Email: