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Membership Renewal
Member Information
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Prefix
First Name
Last Name
Suffix
*

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
*

*




Month and day
Experience & Education
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*

*

(Note: A student nurse (SN) is an unlicensed student in a nursing program. If this does not apply, please type "N/A".)
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Please enter using YYYY format, e.g., 2024
*

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Volunteer
You have a great opportunity to be involved with the organization.

Please select all the committees you are interested in.

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Annual Membership Dues
(Memberships are free for nursing students pursuing their initial RN degree.)