NRN Renewal Membership Application
Thank you for considering continued membership to the NRN. Membership benefits include expanding your network with Native professionals and community members, tax deduction, discounts, voting privileges, committee work, and potential leadership opportunities. As a reminder, annual membership dues are not pro-rated.
Only certain items are required as this is a new form for renewals. Please indicate any CHANGES to the optional fields.
* Required
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Preferred phone number (the original application did not include this option and is missing for all members):
*
Your answer
Job Title
Your answer
Degree(s)/Credentials:
Your answer
Full address (Street, City, State, Zip)
Your answer
The NRN board of directors will only contact you via the contact information you provide. However, as an NRN member, you can have access to information via our social media platforms (facebook and twitter) that will be for members ONLY. Therefore, you may opt out of receiving any information by checking the box below.
I wish to opt out from all forms of contact
Please list NEW professional organizations of which you are a member:
Your answer
Which area best describes your area of research?
*
Biomedical and health sciences (physician, nurses, etc.)
Public health
Basic sciences (chemistry, biology, etc.)
Social and behavioral studies
Traditional knowledge/medicine
Environmental health
Other:
Please list UPDATES to your SPECIFIC research and/or programmatic interest areas:
Your answer
Please list NEW Native communities/populations with whom you are currently working worked:
Your answer
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