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NOVA Membership Survey
NOVA Membership Survey
Please take a few minutes to complete this survey to help us update your membership profile for NOVA.
1.
Full Name (First and Last)
2.
VA Email Address
3.
Personal Email Address
4.
Phone Number
5.
Facility
6.
NOVA Chapter Affiliation
7.
Are you a current officer in your chapter?
President
President-Elect
Secretary/Treasurer
Membership Secretary
Director
N/A
8.
What is the highest degree you have earned?
LPN/LVN, diploma
associate’s degree
bachelor’s degree
master’s degree
post graduate (DNP, PhD)
Other (please specify)
9.
What licenses do you currently hold?
LPN/LVN
RN
APRN
Other (please specify)
10.
What certifications do you currently hold?
11.
What is your current member type?
APRN
RN
LPN/LVN
Emeritus
Associate
12.
Have you taken advantage of the NOVA discounts for certification or education? If so, be specific:
