Vanderbilt Kennedy Center > User Registration

User Registration

Please enter your first name

First Name:*

Please enter your last name

Last Name:*

Please enter your desired username

User Name:*

Please enter your desired password for this portal

Password:*

Please confirm your password

Confirm Password:*

Please enter your email address

Email Address:*

Please enter your telephone number

Phone Number:

Please enter your company name

Company / Agency Affiliation:*

Please enter a value for the field How Many years have you worked at your current company/agency?.

How Many years have you worked at your current company/agency?:*

Please select the group referred for course access

Choose the Vanderbilt Kennedy Center Division for Course Access :*

Select your Country

Country:

What State do you reside in?

State:*

Please enter your home zip code.

What is your home zip code:*

What capacity are you currently working?

Position:*

This is who you are completing the course as. ex: caregiver, VKC Trainee, Classroom Student, Child/Adolescent with Disability

Participant Type:*

Vanderbilt Kennedy Center