Infection Preventionist IP Committee Application

IP Committee Membership Application

A Membership Committee dedicated to Infection Preventionist Professionals
Infection Preventionist Membership Benefits

1) NADONA Membership Benefits

a. Mentoring
b. Scholarships
c. Webinars (Contact Hours and without Contact hours)
d. Discounts on Certification Courses and Exams
e. Discounted price on Registration for NADONA Conference
f. Exclusive Resources on NADONA website for members only
g. The Director
h. LTC Publications Available Chamberlain College of Nursing opportunities

2) Quarterly IP Newsletter filled with articles, updates, new products etc. for the IP

3) Monthly Computer-side chats for IP Members only - Opportunity to ask questions, discuss topics, general peer conversation, attended and hosted by NADONA staff.

4) Quarterly IP Webinars - Outside speakers presenting on hot topics and new rules/regulations.

5) Sponsorship of quarterly meetings (3 virtual meetings and one in person meeting at the national NADONA conference

6) Quarterly board meetings (Includes officers of the IP Committee)

7) “The Director” NADONA’s quarterly journal will have an IP Section dedicated to the Infection
Preventionist.
If you have 10 or more Infection Preventionists who would like to join or would like to inquire about Corporate Memberships – contact sherrie@nadona.org or call 513-791-3628

IP Committee Membership Application

FILL OUT ALL INFORMATION COMPLETELY AND SUBMIT
Type of Application

NewRenew
Applicant Name*

First NameMiddle Name or InitialLast Name
Personal Cell Phone Number*
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Personal Email*
example@example.com
Work Email
example@example.com
Tell us about you
Current Title
Are you a Certified Infection Preventionist

YesNo
License # and State Issued
Type of license (RN, LPN, LVN, etc)
Certification expires in which year?
Are you currently holding the IP position in addition to your Nurse Leadership role in the facility?
Through which organization are you certified?:
Tell us about your career

Payment

Please fill out information completely.
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BECOME A NADONA MEMBER NOW ONLINE TO ENJOY MEMBER BENEFITS WWW.NADONA.ORG

JOIN NADONA LTC Become a Member

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If you have 10 or more Infection Preventionists who would like to join or would like to inquire about Corporate Memberships – contact sherrie@nadona.org or call 513-791-3628

My Products*

NADONA IP Committee MemberI AM CURRENTLY a member of NADONA and would like to join the IP Committee.

$25.00 Membership Length

NON-NADONA IP Committee MemberI AM NOT CURRENTLY a member of NADONA and would like to join the IP Committee.

$125.00 Membership Length

Total

$0.00

Signature*

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Please verify that you are human*
Contributions or gifts to the National Association of Directors of Nursing Administration in Long Term Care, Inc. are not tax deductible as charitable contributions.

However, they may be deductible as ordinary and necessary business expenses.
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IP Committee Membership Application