Graduate or License Renewal Credit

Please use the registration form below to register graduate or license renewal credit.

First name

Last name

Address

City

State

ZIP code

Phone

Employer

Position

Choose the type of credit:

License renewal credit. (1 renewal credit $35) Graduate credit. (1 grad credit $150)

Pay by credit card

Northwestern College accepts the following credit and debit cards:

Name and address same as above.

First name

Last name

Address

City

State

ZIP code

Card type

Expiration date

Card number

Security code

For Visa, Mastercard, and Discover (left), the 3 digits on the back of your card.

For American Express (right), the 4 digits on the front of the your card

Total amount

$0.00

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Graduate or License Renewal Credit

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