Online Application for Membership
*Organization Acronym:
 
*Full Name of Organization:
 
Address:
City:
State:
Zip:
*Phone:
 
Fax:
*E-mail:
 
*Web Page:
 
*Total Number of Members:
 
*Annual Revenue $:
 
Does the organization have non-nurse members:
Percentage of Members Who Are Registered Nurses:
Description of Non-Nurse Membership:
 Membership Fees: $1,000.00
Please choose the appropriate category for your organization:
 Describe below how your organization meets each of the following membership criteria:
Have a mission compatible with that of The Alliance:
Address current and emerging nursing issues:
Have a body of knowledge and skills in a defined area relevant to nursing or health care, supported by documentation that might include a core curriculum, publications and research, standards of care/practice, or other documents:
 Please submit the following information with initial Alliance membership application
 (May submit in paper or electronic form to address listed below.)
*Name, Title, Credentials, Address (fax, phone, e-mail) of organization’s CEO/ED/Account Manager, President, and President-Elect:
 
*Date the Articles of Incorporation for organization were filed:
    Calendar 
*One Copy of Organizational Bylaws or Equivalent:
 
*Name and email address(es) of people you would like subscribed to the listserv:
 
How did you hear about The Alliance?:
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PDF Membership Application Form
Download PDF Membership Application Form
Address

Use the form above or mail all application information to:

Nursing Organizations Alliance™
201 E Main St, Ste 1405
Lexington, KY 40507
FAX: 859-514-9166
Email: alliance@amrms.com