Alumni Bodyworkers and Health EducatorsAlumni Volunteer Application CONTACT INFORMATIONName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* PROGRAM(S) COMPLETEDCore Massage Therapy Program | Group #Core Massage Therapy Program | Graduation DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920NOTE: If you do not remember the exact day of graduation, please enter "1" for the DayAdvanced Neuromuscular Therapy Program | Group #Advanced Neuromuscular Therapy Program | Graduation DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920NOTE: If you do not remember the exact day of graduation, please enter "1" for the DayAVAILABILITYWhat Campus will you be able to PRIMARILY assist?*Choose ONEReddingSacramentoModestoSanta RosaEmeryvilleSan JoseClovisStudio CityOntarioSanta AnaAre there any other Campuses for which you would be available to assist?* NONE Redding Sacramento Modesto Santa Rosa Emeryville San Jose Clovis Studio City Ontario Santa Ana Select ALL that applyAs a Teaching Assistant, I would like to support in the following ways* Engage with Future Students Attend On-Campus Events Attend Off-Campus Events Support Students' Success in the Digital Environment In-Class Support Out of Class Support Support Non-English Speaking Students Support Students with Unique Needs Select ALL that applyFOR IN-CLASS SUPPORT | Select the Course areas in which you feel most confident in supporting students* Anatomy & Physiology (includes Kinesiology) Business Ethics Massage Therapy | Western Segment Massage Therapy | Eastern Segment Clinic Externship Select ALL that applyFOR OUT OF CLASS SUPPORT | Select the Course areas in which you feel most confident in supporting students* Anatomy & Physiology (includes Kinesiology) Business Ethics Massage Therapy | Western Segment Massage Therapy | Eastern Segment Clinic Externship Select ALL that applyFOR SUPPORT NON-ENGLISH SPEAKING STUDENTS | List ALL languages in which you are fluent*Example: Spanish, Portuguese, ItalianFOR SUPPORT STUDENTS WITH UNIQUE NEEDS | Describe skills or training you possess that could be of help to our unique learners*Example: Students who may be vision impaired, hearing impaired, learning impaired, etc.How will your participation contribute to student success and NHI's mission of "Helping People Have Work They Love"?*How will your participation support your career goals as a Bodyworker and Health Educator?*Please acknowledge your acceptance of the following statements* I have read, understand and agree to the statements listed BELOW to participate as an NHI Teaching Assistant.- I will participate in any required trainings to properly represent NHI and the Massage Therapy Profession and effectively support Student Success - I will follow through with the commitments I make with students and staff as noted in this Teaching Assistant Application. - I will uphold NHI’s Standards of Professionalism and Confidentiality both on and off campus. - I understand NHI staff members can contact me regarding my support of current and future students. - If I have indicated a willingness to Engage with Future Students, I understand the email and phone number I have provided may be shared. - I must be in good Financial Standing with NHI in order to participate. - While not the sole assessment tool, I understand that my Professionalism, Attendance and GPA while an NHI student will be used as factors in determining eligibility - I acknowledge that my participation as an NHI Teaching Assistant is “at-will”, either NHI or I can end my participation at any time.EmailThis field is for validation purposes and should be left unchanged.