This determines your organization's dues rate. Tier 1 (Under
$1M): $1,250/year. Tier 2 ($1M or more): $2,500/year.
Please enter your organization name.
Please enter your acronym.
Please enter a valid website URL.
Please enter your total membership count.
Please select how your organization is staffed.
Please enter the name of your management company.
Step 2 of 5
Organization Address
Please enter your street address.
Please enter your city.
Please select your state.
Please enter your zip code.
Please enter a valid email address.
Please enter a phone number.
Step 3 of 5
Membership Criteria
Please select an option.
Please describe your non-nurse membership.
Please enter the percentage of RN members.
Please select your organization category.
Describe how your organization demonstrates 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, or standards of care and practice.
Please complete this field.
Describe how your organization addresses current and emerging
nursing issues.
Please complete this field.
Describe how your organization's mission is compatible with that
of NOA.
Please complete this field.
Step 4 of 5
Documents and Primary Contact
Please enter the incorporation date.
Please upload your organizational bylaws (PDF, DOC, or DOCX).
Accepted formats: PDF, DOC, DOCX. Maximum file size: 10 MB.
Please upload your organization logo (JPG, PNG, or WEBP).
If the person completing this form (the primary contact above)
holds one of these roles, click the button to pre-fill their
information. Click again to clear.
Board President / Chair
CEO / Executive Director
Step 5 of 5
Review and Submit
Something went wrong while submitting your application. Please try
again or contact [email protected].
Your application will be reviewed by the NOA Board of Directors. You
will be contacted regarding next steps.
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