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LIFE MEMBERSHIP
Price:
$200
First Name:
First Name Required
Last Name:
Last Name Required
Email:*
Email is Required
Mobile Number:*
Mobile Number is Required
Credentials:*
Credentials is Required
Street Addres:*
Street Addres is Required
City:*
City is Required
State:*
State is Required
Zip code:*
Zip code is Required
Gender:*
Gender is Required
Male
Female
Other
Prefer not to answer
Highest Degree earned:*
Highest Degree earned is Required
Advance Practice Provider:*
Advance Practice Provider is Required
Nurse Practitioner
Clinical Nurse Specialist
Nurse Midwife
Nurse Anesthetist
Not applicable
How would you like to be involved in INANY?:*
How would you like to be involved in INANY? is Required
Professional networking
Continuing education activities
Mentoring
Career advancement self-help group
Committees/Leadership
Community outreach activities
Not at this time
Position Description:*
Position Description is Required
Nurse Clinician / Staff Nurse
Nurse Informaticist
Academic Educator
Managers / Supervisor / Coordinator
Nurse Scientist
Staff Educator
Patient Educator
Clinical Trial Nurse
Quality Improvement
Director
VP / CNO / CEO
Consultant
Entrepreneur
Nurse Navigator
Nurse Practitioner
Retired
Other
Email:*
Invalid Email
Password:*
Invalid Password
Password Confirmation:*
Password Confirmation Doesn't Match
Password Strength
Password must be "Medium" or stronger
No val
Please fix the errors above
Price:
$200
First Name:
First Name Required
Last Name:
Last Name Required
Email:*
Email is Required
Mobile Number:*
Mobile Number is Required
Credentials:*
Credentials is Required
Street Addres:*
Street Addres is Required
City:*
City is Required
State:*
State is Required
Zip code:*
Zip code is Required
Gender:*
Gender is Required
Male
Female
Other
Prefer not to answer
Highest Degree earned:*
Highest Degree earned is Required
Advance Practice Provider:*
Advance Practice Provider is Required
Nurse Practitioner
Clinical Nurse Specialist
Nurse Midwife
Nurse Anesthetist
Not applicable
How would you like to be involved in INANY?:*
How would you like to be involved in INANY? is Required
Professional networking
Continuing education activities
Mentoring
Career advancement self-help group
Committees/Leadership
Community outreach activities
Not at this time
Position Description:*
Position Description is Required
Nurse Clinician / Staff Nurse
Nurse Informaticist
Academic Educator
Managers / Supervisor / Coordinator
Nurse Scientist
Staff Educator
Patient Educator
Clinical Trial Nurse
Quality Improvement
Director
VP / CNO / CEO
Consultant
Entrepreneur
Nurse Navigator
Nurse Practitioner
Retired
Other
Email:*
Invalid Email
Password:*
Invalid Password
Password Confirmation:*
Password Confirmation Doesn't Match
Password Strength
Password must be "Medium" or stronger
No val
Please fix the errors above
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