Signup Form

Please correct one or more form errors.

Legal First Name

As it appears on your state-issued identification card or license.

Legal Last Name

As it appears on your state-issued identification card or license.

Year of Birth

Email Address

Confirm Email Address

Password

Show Password Hide Password

Password must:
1) be at least 8 characters,
2) contain both upper and lower case,
3) contain both letters and numbers.
4) does not contain words like delete, update, select, exec, cmd, shell, varchar, waitfor, or declare.
Password is case-sensitive.

Confirm Password

Show Password Hide Password

Highest Degree Earned

Ethnicity

Gender

Contractual Agreement

This site may ask you to provide contact and identifiable information including, but not limited to, name, email address, professional license, employer, work address, job category, and credentials for the purposes of site membership, event registration, obtaining continuing education credits, tracking, evaluation, providing a service you request, or otherwise. In some instances, including those listed above, but not limited to, this information may be shared with accrediting institutions, your employer, your provider, your PIHP or evaluation partners of Detroit Wayne Connect Training.

Your information will not, under any circumstances, be sold, or be used for any circumstances that intend to cause you harm in any way.

This site may also share training and test results with accrediting institutions, your employer, your provider, your PIHP, or evaluation partners of the Detroit Wayne Connect. Federal law, specifically 20 USCA 1232g, may prohibit us from sharing this information to the above listed entities without your permission. For more information regarding your rights under federal law we strongly encourage you to review the federal act.

Neither agreement to participate in a DWC survey nor registration for an event is consent to receive correspondence concerning unrelated material. Consent to receive correspondence concerning other DWC material is evidenced by a person or entity "accepting" these terms of use. In order to opt out of the DWC mailing list, a person or entity must "unsubscribe" to the emails using the link at the bottom of said promotional emails. Those who wish to cease receiving such materials may indicate their choice by clicking on the "Unsubscribe Here" link within the undesired email. DWC agrees to send DWIHN-related correspondence only to those persons and entities who currently consent to receive it. Automatic emails in response to your activity on the DWIHN website are not included in this "opt out" option. Correspondence generated in response to event registration and other interaction with the website will still be sent.

I "ACCEPT" the Terms of Use

Password must include:

At least one letter
At least one capital letter
At least one number
At least 8 characters

Signup Form

Please correct one or more form errors.

Password must include:

Quick Links

Contact Us

Help Desk