Membership Application
I WOULD LIKE TO BE A MEMBER - of the National Network of Career Nursing Assistants and enjoy the benefits of a noted professional organization for, by and with direct caregivers in long-term care services:
Individual Nursing Assistant Membership $25/Year
Facility Membership, NA Group or Chapter, Provisional Chapter: $100/Year
Twenty Year Club Membership: Individual nursing assistant eligible for scholarship - no cost to NA (go to twenty year only form)
Twenty Year Club Membership: For non-member facilities , groups and organizations $10/ person
Corporate membership: Entitles the Corporation or selected groups within the Corporation to host one workshop. Also provides discounts for additional workshops, programs or other services to your members. Save also on Twenty Year Club membership when submitting as a Corporation. (For more information about corporate membership. E-mail - [email protected]
Friends of Nursing Assistants: Donations and sponsor funding gratefully accepted. For more information about sponsor opportunities, E-mail - [email protected]
Name
Title
Facility/
Organization
Address
City
State
 Zip
Phone
Fax
Email
 
Number of years if enrolling in the Twenty Year Club
Enclosed amount $
Make checks payable and mail to:
National Network of Career Nursing Assistants
3577 Easton Road
Norton, Ohio 44203-5661
PH - (330) 825-9342
FAX - (330) 825 9378
 
For more information contact:
Genevieve Gipson RN MEd RNC, Director,
National Network of Career Nursing Assistants,
3577 Easton Road, Norton, Ohio 44203,
(330) 825 9342. (330) 825 9378-fax.
[email protected] - email

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