2025 Student Ambassador Interest Form
Name
*
First Name
Last Name
Email
*
Personal Email - Do not use your school email
What School Are You Enrolled?
*
Please Select
Canadian Memorial Chiropractic College - Toronto
Cleveland University – Kansas City College of Chiropractic
Keiser University
Life University (GA)
Life West University (CA)
Logan University
National University of Health Sciences - IL
National University of Health Sciences - FL
Northwestern Health Sciences University - MN
Palmer University - FL
Palmer University - IA
Parker University
Sherman College of Chiropractic - SC
Texas Chiropractic College
University of Western State - Oregon
If your school is not listed, please email - stonder@carrickinstitute.com
What is your anticipated graduation date?
*
Do you have a NeuroClub at your school?
*
Yes
No
I'm unsure
What would make you a great fit to be an ambassador for your school?
I have read and reviewed information about the Ambassador.
*
Yes, I have reviewed the information and responsibilities of an Ambassador
Submit
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