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Organization:

Clinical Nurse Specialist Association of Canada

Event:

CNS-C / ICS-C Membership-2024

Date/Time: Mon, 01-Jan-2024 - Tue, 31-Dec-2024
First Name:    (*)
Last Name:    (*)
Address:     (*)
Apartment: 
City:     (*)
Postal Code:     (*)
Prov./State: 
Country:     (*)
Home Phone:     (*)
Business Phone: 
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Email:     (*)
  I have read and agree with the Terms of Use   (*)
 
Please ensure to select only one (1) membership category either of $65 or $50.
 
Current Employer /Agency:   (*)
Title of Position:   (*)
Clinical Specialty Focus:   (*)
Primary Nursing Practice Area:   (*)
 
Degree(s)/ Credential(s) (identify all the ones that apply):
· Master - Nursing: MN/M.ScN./M.Sc. (for example):
Year Completed:
· Other type of Masters:
Year Completed:
· PhD or doctoral education:
Year Completed:
Membership category with Masters (a member):
 
Which territory or province are you registered in?:    (*)
 
 
Registration Number - RN/Registered Psychiatric Nurse:
 
Other types of membership – Affiliates (identify all the ones that apply):
 
 
 
Other (specify):
Membership Categories (Affiliates – not-a-member):
 
I give CNS-C permission to circulate my name, title, specialty focus & contact information to other members of CNS-C (if required).
Contact Info Consent: Yes   No   (*)
 
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Fees are non-refundable once submitted.
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