Chapter Application for Georgia Association of Nursing Students Constituency
Complete and submit this form by October 1st prior to the fall GANS Annual Convention. Information submitted through this form will be used to update your chapter's status as a GANS constituent and is required for credentialing delegates from your school to be seated in the House of Delegates. If you have questions or concerns regarding the form, please contact the GANS Legislative Director at Legislative@ganursingstudents.com.
Full Name
*
First Name
Last Name
School Name
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School District
*
North
South
East
West
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Advisor Contact Information
*
First Name
Last Name
Title
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
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Dean Contact Information
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
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Chapter President Contact
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Date Elected
*
-
Month
-
Day
Year
Date
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Number of NSNA Members in Chapter
*
Number of Members attending GANS Convention
Submit
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