New Member Sign Up - Stateline Nurses Network

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APPLICANT INFORMATION

Full Name:*

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Personal Email:*

Current Employer*

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Credentials (i.e., RN, BSN):*

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Committees Interested In:*

Nurses Expo

Nursing Advancement

Publicity

Pain Resource

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SNN Membership # (renewing members only):

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With your membership and payment of dues, you are consenting to share your contact information above among other SNN members for the purposes of networking, collegiality, and advancing the nursing profession. Your information will NEVER be sold or shared with any other agencies, business, or organizations. We are not affiliated with any other entities.

Full Annual Payment for Membership Dues: $20*

*CHECK OR MONEY ORDER PAYABLE TO STATELINE NURSES NETWORK
*Online payments include an additional $5 processing fee

Website: statelinenurses.org/membership

Email: Statelinenurses2013@gmail.com

Membership Privileges:

Participation in Stateline Nurses Network activities
Opportunity to serve on Stateline Nurses Network committees
Vote in matters pertaining to Stateline Nurses Network
Discounts at special Stateline Nurses Network sponsored events
Represent Stateline Nurses Network at select community events

RETURN COMPLETED APPLICATION WITH PAYMENT TO:

STATELINE NURSES NETWORK
c/o Patricia Hall
5818 Gridley Court
South Beloit, IL 61080

QUESTIONS?

Email: Statelinenurses2013@gmail.com

Phone: 815-871-3625

Website: statelinenurses.org/membership

Membership Dues (A $5.00 fee has been added for online submission)

Price: $25.00

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