ASNG Membership Application/Renewal Form
Our membership year ends in May; the cost of an individual annual membership is $40 (if joining after January membership is $20).
Name *
Your answer
Are you an existing member *
If you are an existing member which cluster group do you belong to:
Nursing qualification *
Your answer
Post graduate qualification *
Your answer
Practicing certificate number *
Your answer
Practicing certificate expiry date *
MM
/
DD
/
YYYY
School *
Your answer
School address *
Your answer
School phone number *
Your answer
Work email *
Your answer
Home email (only if you wish to receive ASNG correspondence through this)
Your answer
Thank you for your membership application/renewal, you will receive an email shortly with more information.
Submit
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