2025 Registration Update - DRAFT - v1 | UNCLCN Learning Portal

Email *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Prefix

First Name *

Middle Name

Last Name *

Preferred Pronouns

Enter your pronouns as you would like others to refer to you. For example: she/her/hers, he/him/his, they/them/theirs, etc. You may skip this field if you prefer to not answer.

Street

Additional Address Information

City *

Country *

Country Other

State/Province *

Postal Code *

Cell Phone Number

To receive lecture notices via text message (please include area code) — US only

Primary Profession *

Please select the profession that best describes your current practice or role.

Primary Profession Other...

Credentials *

What degrees and credentials would you like listed after your name?

UNC Affiliate Status *

UNC Affiliate Status Other (please list affiliation)

UNC PID (Personal ID #)

Providing this number will expedite the processing of your CME credit applications but is not required.

Employer or Organization *

Employer or Organization Other Organization/Affiliation

What type of Continuing Education credit are you interested in? *

(If you do not see your CE credit type listed, select "Other" and let us know what credits to offer in future courses)

What type of Continuing Education credit are you interested in? Other

Degree, Certification, or License that requires CME credits

This information is required to apply for CME credit in accordance with the UNC School of Medicine CPD Office. Please enter this information if it differs from your primary profession selected.

Please provide your NABP eProfile ID Number. *

Your NABP e-Profile ID is required to process ACPE credit requests. Without this number, downloading an ACPE certificate from accredited webinars or courses may result in delays or failure for credit to be applied

Date of Birth *

Month

Day

Year

Please provide your ASRT ID Number *

To prevent delays in reporting, please provide a unique identifying number. This could be your ASRT number, ARRT number, or another organization's unique ID associated with your identity. Without this number, downloading an ASRT certificate from accredited webinars or courses may result in delays or failure to apply credit. (Do not provide your SSN)

I would like to sign up to receive monthly email newsletters and event updates from UNCLCN. *

Do you have an alternative email address? *

An alternate email address is useful for account recovery in the event that you leave your organization and no longer have access to your current work or school related email account.

Yes

No

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2025 Registration Update - DRAFT - v1