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* 1. Name

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* 2. Email address

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* 3. Phone Number

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* 4. Are you an Indian River State College Honor Society in Nursing Member?

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* 5. Please provide your RN License if you wish to receive CEU's

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* 6. Please pay with check or at the door the night of the event. 

Mail checks payable to the Honor Society in Nursing: 

Honor Society in Nursing
Nursing Department
Indian River State College
3209 Virginia Ave
Fort Pierce, Fl 34981

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