CANN: Apply for CANN membership

Email *

Password *

Confirm Password *

Title *

First Name *

Last Name *

Address *

City *

State *

Country *

Postal Code / Zip Code *

Address is *

Home Work

Telephone *

Alternate Telephone

Employer

Years in nursing *

Years in neuroscience *

Provincial registration number *

CNA member *

Yes No

CNA certified *

Yes No

CNA certification number

Educational background *

Diploma BN or BSN MS/MSN PhD Licensed Practical Nurse Registered Practical Nurse

Practice setting *

Academic Ambulatory Community Hospital Rehab Facility University/Teaching Hospital Other, please specify

Primary clinical focus *

Primary practice population *

Neonatal Pediatrics Adults Geriatrics

Primary practice area *

Critical care Medical-surgical Outpatient Perioperative Other, please specify

Work function *

Membership Type *

General ($85)

Associate ($65)

Canadian Association of Neuroscience Nurses (CANN) L’Association canadienne des infirmiers et infirmières en neurosciences (ACIIN)