NPAIHB BHA Student Agreement Form

NPAIHB BHA Student Agreement Form

The below outlines the expectations and requirements for the BHA Education Program through Northwest Indian College (NWIC) and Heritage University (HU). This parternship is supported by the Tribal Community Health Provider Program (TCHPP) at the Northwest Portland Area Indian Health Board (NPAIHB).
Your Name*

First NameLast Name
Your Email*
example@example.com
Your Phone Number*
School Name*
Expectations:

I understand that I am required to attend the TCHPP's BHA Orientation with my cohort in year 1 of the program.I understand that I am highly encouraged to attend the NW Elders, Knowledge Holders, and Culture Keepers ECHO at least 6 of the 12 times they occur, each year.I understand that in order to be eligable for National Certification for BHA through the Portland Area CHAP Certification Board (PACCB), I need to be working for a Tribe or Tribal Health Department.I understand that I will need to log my work experience hours (2,000 hours total) and clinical practicum hours (200 hours total) with my Clinical Supervisor if I would like to pursue National Certification.I understand that I am expected to partake in 30-minute monthly check-ins via Zoom with the NPAIHB BHA Program Staff.I understand that I will need to submit grades, course schedules, tuition ledgers, financial aid/scholarship information and any school related documents that the TCHPP BHA Program staff request.I understand that I need to submit my grades to the BHA Program Manager at the end of each term, each year.I understand that the stipend funding will be sent to me in the mail and it is my responsiblity to budget and pay for my tuition and school supplies with that stipend funding.I understand that I am required to notify the NPAIHB BHA Program Manager if I take a leave of absence or if I am put on furlough.
I hereby acknowledge that by checking the boxes above that I understand BHA student expectations and requirements.
Student Signature*

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