Annual Affiliate Member

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Provides 12 months of membership with eligibility to renew membership.
Annual affiliate members are not eligible for tuition discounts and reduced cost offers for events organized by IANANT.

Qualification for Affiliate Membership shall be:

Affiliate membership will be extended to individuals irrespective of Indian origin or heritage if they share the mission, vision, and values of IANANT to include but not be limited to Registered Professional Nurses, nursing students, Licensed Practical Nurses (LPN), Licensed Vocational Nurses (LVN) and other healthcare professionals. The affiliate members do not hold offices or participate in decision making process and do not have voting privileges but may enjoy all other benefits of IANANT membership as a member by paying Affiliate Membership fee.

Annual Affiliate Membership Form

Price:

$50

First Name:* First Name Required

Last Name:* Last Name Required

Email:* Email is Required

Mobile Phone:* Mobile Phone is Required

Street Address:* Street Address 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

Birth Date:* Birth Date is Required

Birth Month:* Birth Month is Required

Highest Degree earned:* Highest Degree earned is Required

Credentials:* Credentials is Required

Speciality Certification: Speciality Certification is not valid

Advanced Practice Provider:* Advanced Practice Provider is Required

Nurse Practitioner Clinical Nurse Specialist Nurse Midwife Nurse Anesthetist Not applicable

How would you like to be involved in IANANT?:* How would you like to be involved in IANANT? 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 / 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

Description	Amount
Annual Affiliate Member – Payment	$50.00
Total	$50.00

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Annual Affiliate Membership Form

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