Minnesota Affiliate Chapter for the Association of Nursing Professional Development

This form will include your information on the membership roster so that you are informed about meetings and other news that is related to nursing professional development. This information is shared with ANPD as per their rules on affiliate formation. There is an intention to also share this information among other members for networking and communication purposes, but you may opt of this sharing if desired. Membership is completely voluntary and you may opt out at any time.

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* 1. First Name/Last Name

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* 2. Credentials/Title

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* 3. Street Address:

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* 4. City, State, zipcode:

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* 5. Area(s) of expertise

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* 6. Organization/Where do you work?

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* 7. Cell or home phone

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* 8. Work Phone

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* 9. Email Address

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