Intern Exam Registration On-line NCREHS Exam Online Registration V1.0 –2024 Your InformationIntern Name(Required) First Middle Last Suffix Work Email(Required) Mobile Phone(Required)Employer Name(Required)AlamanceAlexanderAlleghanyAnsonAppalachian District HealthAsheAveryBeaufortBertieBladenBrunswickBuncombeBurkeCabarrusCaldwellCamdenCarteretCaswellCatawbaChathamCherokeeChowanClayClevelandColumbusCravenCumberlandCurrituckDareDavidsonDavieDuplinDurhamEdgecombeForsythFranklinGastonGatesGrahamGranvilleGranville-Vance Public HealthGreeneGuilfordHalifaxHarnettHaywoodHendersonHertfordHokeHydeIredellJacksonJohnstonJonesLeeLenoirLincolnMaconMadisonMartin-Tyrrell-Washington District HealthMartinMcDowellMecklenburgMitchellMontgomeryMooreNashNew HanoverNorthamptonOnslowOrangePamlicoPasquotankPenderPerquimansPersonPittPolkRandolphRichmondRobesonRockinghamRowanRutherfordSampsonScotlandStanlyStokesSurrySwainToe River Health District DepartmentTransylvaniaTyrrellUnionVanceWakeWarrenWashingtonWataugaWayneWilkesWilsonYadkinYanceyWork Address(Required) Street Address Address Line 2 City North CarolinaAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Work Phone(Required)Intern Number(Required)Last 4-Digits of Social Security Number(Required)Supervisor's Name(Required) First Last Supervisor's Title(Required) Type of Exam Registration, Select One or Both(Required)Fees: NEHA Registration $280 Essay-Interview $50. Once selecting Essay-Interview, you will be presented with dates for 2024. NEHA Exam Registration Essay-Interview SessionsThis field is hidden when viewing the formEssay-Interview. Select One (20 person Max per session. All dates are hosted in Mebane, NC.) December 5, 2024 AM December 5, 2024 PM This field is hidden when viewing the form2nd Choice Essay-Interview. Select One (15 person Max per session) August 22, 2024 AM August 22, 2024 PM October 24, 2024 AM October 24, 2024 PM December 5, 2024 AM December 5, 2024 PM Essay Topic Select One Food and Lodging On-Site Payment DetailsNEHA Exam Registration Price: Essay Interview Fee Price: Total Charges Payment Type(Required) Register Now Pay Now Register Now Mail Check Note: When paying with a credit card whether its a personal one or your County card, please include the address associated with this credit card. Your payment maybe declined if these do not match up.Credit Card Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Credit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name NameThis field is for validation purposes and should be left unchanged. Δ