CPN Certification Kit Request Form

Thank you for informing nurses about PNCB's Certified Pediatric Nurse (CPN) exam!

Due to the pandemic, PNCB staff will be working remotely and unable to process mailings. If you need materials, please contact info@pncb.org about our digital options.

Provide the details below and we'll send you a kit of our most popular materials to share with nurses. Allow 3 weeks for delivery. For U.S. and Canadian addresses only.

Question Title

* 1. How many pediatric RNs will you be informing? For requests higher than 100, email info@pncb.org with your event information and FedEx number to offset shipping costs.

Question Title

* 2. If you need your kit by a certain date, enter it below.

Please provide at least 3 weeks' notice. Orders needed sooner than 3 weeks will be fulfilled as quickly as possible, but might not make your need-by date.

MM/DD/YYYY

Date

Question Title

* 3. What is your full mailing address?

Name: *

Hospital/Healthcare Facility:

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number:

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* 4. What is your title/role?

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* 5. Do you need a small giveaway (e.g., pens or other item we provide) for these RNs?

Yes

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* 6. Are you interested in PNCB's No Pass, No Pay no-risk CPN testing program?

Yes, please contact me

No, we are not interested at this time

We already offer it

Question Title

* 1. How many pediatric RNs will you be informing? For requests higher than 100, email info@pncb.org with your event information and FedEx number to offset shipping costs.

Question Title

* 2. If you need your kit by a certain date, enter it below. Please provide at least 3 weeks' notice. Orders needed sooner than 3 weeks will be fulfilled as quickly as possible, but might not make your need-by date.

Question Title

* 3. What is your full mailing address?

Question Title

* 4. What is your title/role?

Question Title

* 5. Do you need a small giveaway (e.g., pens or other item we provide) for these RNs?

Question Title

* 6. Are you interested in PNCB's No Pass, No Pay no-risk CPN testing program?

Question Title

* 7. Please share any additional information about your request below. Thank you for promoting CPN certification!

* 2. If you need your kit by a certain date, enter it below.

Please provide at least 3 weeks' notice. Orders needed sooner than 3 weeks will be fulfilled as quickly as possible, but might not make your need-by date.