Career Nurse Assistants'


Twenty Year Club '98


Application Form

Date:

Facility:

Contact Person:

Postion:

Address:

Phone:

City:

State:

Zip:

We grant permission to Career Nurse Assistants' Programs, Inc. to use the name of this facility in the directory and other related publicity.
    Yes
    No
Representative:

The individual nurse assistant must grant permission for use of her/his name in the directory and other publicity. Please initial in the space provided to indicate this permission.

Please consider the following nurse assistants as Honorary Members of the Twenty Year Club'98:

NAME AS IT IS TO APPEAR ON CERTIFICATE# years of
service		Permission to
use name(please
initial)
1.
2.
3.
4.
5.
6.
7.
8.

Your Email:

To receive certificates for Nurse Assistants' Week and Career Nurse Assistants' Day , applications must be received by May 10, 1998. To apply for recognition for "Most Service Years," applications must be received by August 10, 1998.
Mail completed form to: Career Nurse Assistants' Programs, Inc.
3577 Easton Road
Norton, Ohio 44203-5661 PH: (330) 825 9342


Home Page |  Facts about Nursing Assistants |  The Role of Nursing Assistants |  Leadership Conference
National Forum |  Tips 5 - Specialists In The Art of Caring |  National 20 Year Club
Nursing Assistants' Week |  National Classroom |  Talk To Me! - Membership Form / Comments
Order Form


Career Nurse Assistants' Program, Inc
3577 Easton Road    Norton, Ohio 44203-5661
PH (330) 825-9342     FAX (330) 825 9378
E-mail [email protected]
Career Nurse Assistants, Inc. and National Network of Career Nursing Assistants
© Copyright 1998 Career Nurse Assistants' Programs, Inc. All rights reserved.

Award-winning web site design and fast hosting by Empowering You!
Website: http://www.empoweringyou.com   E-mail: [email protected]  
Phone: 330-375-0060    FAX: 330-375-0061