National Indian Justice Center

Please provide the following information if you would like to be enrolled in the Preparing a Healthy Path: Planning and Implementing Tribal Adult Healing to Wellness Courts for Participants Who Have FAS/FAE. This information will be used solely for the purpose of establishing your enrollment in the course and providing you with a username and password.

(* indicates required)

Email Address *
First Name *
Last Name *
Do you work for a Tribal Drug Court *	Yes No No, my court is no longer an active tribal drug court. Not Sure
Mailing Address	Street Address Address Line 2 City State/Prov/Region Postal/Zip Country
Phone	( ) -
Fax	( ) -