KBUG Educator Registration Registration If you are a human and are seeing this field, please leave it blank. Educator Registration Information First Name * Last Name * Email * Phone * Cell Phone Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampsire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code * Tribal Affiliation Educator Information What is your title? Would you like to Volunteer? YesNo I will be attending sessions If you would like to Volunteer, when are you available? All Day 7:30-3:30Morning 7:30-11:30Afternoon 11:30-3:30Other If other please explain Are you familiar with the campus? YesNo Photo Release The American Indian Graduate Center (AIGC) has my permission to use my or my child’s photograph publically to promote the organization. I understand that the images may be used in print publications, online publications, presentations, websites and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. * I agreeI do not agree By checking this box and typing my name below, I am electronically signing this Photo Release. * Are you under 18? * YesNo If you are under 18 your parent pr guardian is required to electronically sign this Photo Release. Parent or Guardian Signature I agreeI do not agree By checking this box and typing my name below, I am electronically signing this Photo Release.