Lac Courte Oreilles Ojibwe College Extension
Natural History Trips Community Education Unit Registration
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Lac Courte Oreilles Ojibwe College CEU Registration Form
Natural History Field Trips 2021
First Name *
Last Name *
Email Address *
Telephone Number *
Please check the transportation you would prefer. NOTE: Our van only holds a certain amount of people but we will do our best to plan accordingly for the van.
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Mailing Address *
Address - City *
State *
Zip Code *
Date of Birth (mm/dd/year) *
Are you a tribal member or descendant of a federally recognized Tribe? *
Reservation of Enrollment or Descendancy *
I hereby authorize the Tribal Enrollment Department to release an OFFICIAL tribal blood certification to the Lac Courte Oreilles Ojibwe  College at 13466W Trepania Road, Hayward, WI 54843 ATTN:  Registrar’s Office, for the purposes of college enrollment only.  I understand the information is confidential and the above organization will use it only for the stated purpose.   *
Required
By checking this box I give LCOOC Extension Dept the right to record and photograph my (and the minor children under my supervision) participation in this workshop.  The photos may be used to market and promote Extension programming and may be used on the website, social media, newsletters, and other articles.   *
Required
Do you want to receive a certificate of completion by mail? *
LCOOC Natural History Field Trips 2021- Check all that you will attend, then you only need to submit this form 1 time.   *
Required
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