Alumni Membership Form
Congratulations on your graduation!

Thank you for taking the time to complete your alumni membership information. NSSRH is a fast growing community of like minded nurses. By completing this form, you will have access to NSSRH alumni programming, our weekly update with national job listings in abortion and family planning, networking opportunities, and more.

New graduates have access to conference scholarships for six months after graduation, and are eligible for travel support for the NSSRH Annual Activist Conference!

The NSSRH Team
First Name *
Your answer
Last Name *
Your answer
Credentials *
Your answer
Place of employment or institutional affiliation
Your answer
Current, NON INSTITUTIONAL, email address *
Your answer
Permanent mailing address(Street, City, State, ZIP):
Your answer
Phone number
Your answer
If you are a new graduate, what are your plans after graduation?
Your answer
If you are not a new graduate, please let us know where you work, and what your job is.
Your answer
Are you interested in participating in the NSSRH Mentorship Program? (This program matches new graduates with mid and late career nurses for a 9 month, 1 on 1, professional development mentorship). *
Are you interested in working to change the NCLEX exam to include SRH topics? *Requires a masters degree in nursing. *
Which of the following best represents your racial or ethnic heritage? Choose all that apply. *
Would you like to participate in our people of color caucus? This group is open to all members who identify as any race or ethnicity other than Non-Hispanic White or Euro-American.
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