NYC Chapter AAMN Membership Form

PRIMARY MISSION
The primary mission of the Chapter is to be the acknowledged local and regional organization for men in nursing.
PURPOSE
The purpose of this organization is to provide an environment for current and prospective nurses which encourage personal and professional development while exploring the unique contributions of men to the nursing profession.
OBJECTIVES
1. Encourage men of all ages to become nurses and join together with all nurses in strengthening and humanizing health care.
2. Support men who are nurses to grow professionally and demonstrate to each other and to society the increasing contributions made by men within the nursing profession.
3. Advocate for continued research, education and dissemination of information about men’s health issues, men in nursing, and nursing knowledge at the local and national levels.
4. Support members’ full participation in the nursing profession.
Application Form
Membership Status *
Membership Level *
Recruited By (Optional)
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First Name *
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Personal Information
Middle Initial
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City *
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Last Name *
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Preferred Mailing Address *
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State *
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Preferred Contact Telephone Number *
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Alternate Telephone Number
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Zip Code *
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Preferred Email Address *
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Alternate Email Address
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Demographic Information
Sex
Date of Birth
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Ethnicity
Education Information
Year of Nursing Degree Completion
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Projected Year of Completion if still in School
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Highest Degree *
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Name of School
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City
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State
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Program Specialty
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Area of Study
Main Area of Study
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Other Areas of Study
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Type of Practice Role Performed
Employer
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Main Practice Role *
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