UTPB Certificate & Continuing Education Registration

Biographical and Demographic Section

Email Address (Primary contact method)

First Name

Middle Name

Last Name

Phone Number

Is this a cellphone or a home telephone number

Home/Landline

Cellphone

May we contact you through your cellphone?

No

Yes

Social Security Number / National ID

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Are you a US Citizen

Yes

No

Which country do you have primary citizenship with?

Gender

Race

What is your gender?

Marital Status

Education History

Have you attended classes at UT Permian Basin before?

Yes

No

Do you remember your Student ID number?

Yes

No

What is your student ID number?

Highest level of study, Degree conferred

The school that awarded the degree

Occupation and Certification History

Military Service

Are you a current or former military service member, or a family member of one?

Yes

No

Please describe your military status

Current Occupation

Current position / title

Company name

Other relevant certifications held

Certification Request

What Academic Semester do you want to start?

Students can take individual courses to keep up with continuing education requirements, or they can complete all the required coursework and receive the certification. Which type of student best represents you?

Individual Coursework

Complete Certification

Which certificate program are you registering for?

Diversity, Inclusion, and Health Equity Certificate

Health Informatics & Leadership certificate

Health Informatics and Leadership Certificate Courses

NURS 4344 Informatics and Innovation
NURS 4343 Fiscal and Organizational Leadership
NURS 4342 Quality Improvement and Healthcare Systems
NURS 4341 Healthcare Leadership and Policy

Diversity, Inclusion, and Health Equity Certificate Courses

HSHP 4310 Social Determinants of Global Health
HSHP 4315 Bias, Stereotypes, and Uncertainty in Clinical Decision Making
HSHP 4320 Personal, Interpersonal, and Group Communication Skills
HSHP 4325 Assessment of Health Outcomes and Individual Satisfaction
HSHP 4330 Promotion of Health and Wellness Literacy
HSHP 4335 Quality Improvement in Diversity, Equity, and Inclusion

Nursing Credentials (if applicable)

Nursing License Number

Is your license unencumbered?

Yes

No

Is your license from a compact state?

Yes

No

Which State?

Emergency Contact Information

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Relationship