Nurse Think Tank Interest form
Activism and the Art of Nursing - July 13-14, Augusta, GA.
Information collected here will never be sold. This information is being collected to solicit interest and coordinate logistics.
What is your name?
What is your email address?
What is your cell phone number?
Tell us about you!
Tell us about why you are interested in participating in our Nurse Activism Think Tank.
Do you have special talents you'd like to share?
What region are you from?
Outside the US
If you chose "Outside the US" for your last response, where are you coming from?
How definite is your attendance?
I'm hoping to attend but seems unlikely
I AM THERE!
How will you arrive?
Willing to carpool and/or share accommodations?
Can we share your responses to facilitate organization?
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