JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
RIIN Interest
Are you interested in being apart of the Rural Immersion Institute of the North (RIIN)? If so, please complete this form. If you have questions, please contact Spencer Toft at satoft@alaska.edu.
*This interest form is for RIIN 2024
* Indicates required question
Name
*
Your answer
Email
*
Your answer
Address
*
Your answer
Phone number
Your answer
Anticipated Graduation Date (mm/yyyy)
*
Your answer
Major and Degree Type
*
Your answer
Healthcare Interests
*
Rural AK Health
Substance Use
Trauma Informed Care
Geriatrics
Public Health
Chronic Disease
Homelessness
Other:
Required
School
*
Your answer
How did you hear about RIIN?
*
Your answer
Comments
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of UA.
Report Abuse
Forms