Membership Application Form

Membership:
N.I.S.C.N.E. has two categories of membership, Full Member and Associate Member.


A Full Member is a Registered Nurse directly or indirectly involved in Nursing Informatics,
pays annual dues of $45.00, and participates in voting.


The Associate Member is a non-RN (or retired RN) who is interested in Nursing Informatics,
pays annual dues of $45.00, and is non-voting.
 

Submit the membership information below, and

mail checks to:
NISCNE c/o Debra Furlong
52 Walnut St
Millis MA 02054
 

Name:

Professional Credentials:

Phone:

Fax:

Organization:

Address 1:

Address 2:

City, State,Zip:

Email address:

I am mailing my dues payment for:

 

 

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