Start Application

Address Line 1:

Address Line 2:

Please include apartment or suite number with your street address.

City:

State/Province:

Zip/Postal Code:

Email:

Phone:

Cell Phone:


Please upload a copy of your military ID. Click here for recommendations on uploading files.


Are you the spouse of an active member of the military?	Yes	No


Please upload a copy of your dependent military ID. Click here for recommendations on uploading files.


Are you coming to North Dakota on military orders?	Yes	No


Password:	Confirm Password:

Application for Genetic Counselor Licensure