Lowcountry Black Nurses Association Membership Form

New or Renewing Member

NewRenewing

Name

First NameLast Name

E-mail

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Birth Date

MonthDayYear

Membership Type

If you are a licensed member, please indicate your nursing specialty? Add nursing specialty

If you are a student member, please indicate the school/nursing program you are enrolled in. Add school/nursing program

How did you hear about us?

Preferred way to contact

PhoneEmailAny

1. Membership is open to Registered Nurses (RNs), Licensed Practical/Vocational Nurses (LPNs/LVNs), retired nurses, and nursing students.

2. Members must also be a member in good standing with the National Black Nurses Association (NBNA). Visit www.nbna.org to complete your online membership application.
Step 1: Click on Membership > scroll down to “Online Membership Application”
Step 2: Follow the instructions to set up your account and to complete the online membership application.
Step 3: When it asks, "Chapter you are joining", enter "LOWCOUNTRY BLACK NURSES ASSOCIATION." If Lowcountry Black Nurses Association is not listed yet, enter "DIRECT MEMBER" for now.
Step 4: Under "Recruited by" enter “LOWCOUNTRY BLACK NURSES ASSOCIATION.”

3. Members must support the mission, vision, and values of the Lowcountry Black Nurses Association (LCBNA), as well as the NBNA.

4. Members agree to pay biannual local dues of $50. The first $50 is due within 30 days of membership. The remainder will be due by October 31, 2024. *Student members are exempt from the local dues at this time. Payments can be made to Sharon Simmon, Treasurer, via CashApp at $SS1mmons. *Student members are exempt from the local dues at this time.

5. Student members are asked to supply the chapter with a letter from the school, on school letterhead, and signed by the Administrator, indicating that you are unlicensed.

Membership Agreement

I have read, understood, and accepted the rules for membership.

Once you submit your application, we will contact you shortly to complete your membership application.

Thank you!

Lowcountry Black Nurses Association Membership Form

Membership Rules