Membership Application

Important Information! PLEASE READ EVERYTHING BELOW!!!

Dues&#13;&#10;-Please submit your dues with your application submission. &#13;&#10;(Either by Check/Cash, Venmo or CashApp)&#13;&#10;-Yearly dues are $40&#13;&#10;Due on January 1st of each year, with a grace period of 45 days but must be paid by February 14th.&#13;&#10;&#13;&#10;Dues are prorated (if you join: )&#13;&#10;January 1-June 30: $40&#13;&#10;July 1st -December 31st : $20&#13;&#10;&#13;&#10;All new members/returning members are eligible for the following: &#13;&#10;1st year–    a logo T-shirt&#13;&#10;2nd year–  logo canvas bag&#13;&#10;3rd year–   logo garment bag, etc.&#13;&#10;What are the dues used for? Business expenses, i.e. tax filings; tribute materials, i.e. roses, lamps, cards, postage, parade registration/supplies, general office supplies, expenses as they arise.&#13;&#10;&#13;&#10;Paying Dues: &#13;&#10;&#13;&#10;Make Checks out to: &#13;&#10;West Tennessee Nurses Honor Guard&#13;&#10;In c/o Lisa Kisling&#13;&#10;1765 Meacham Rd.&#13;&#10;Dyersburg, TN 38024&#13;&#10;&#13;&#10;Venmo go to this link: &#13;&#10;https://www.venmo.com/u/Jessica-Clepper&#13;&#10;&#13;&#10;CashApp go to this link: &#13;&#10;https://cash.app/$JC3522&#13;&#10;&#13;&#10;&#13;&#10;Uniforms&#13;&#10;WOMEN&#13;&#10;● White knee length dresses or&#13;&#10;     scrub top & pants&#13;&#10;● Women’s white nursing shoes&#13;&#10;● White stockings for women and white or skin toned undergarments&#13;&#10;&#13;&#10;Nurses Cap can be ordered through Kayscaps.com &#13;&#10;Item #722 (smaller size) or #7223 (larger size)&#13;&#10;(white cap with black stripe) &#13;&#10;Nurses Cape can be ordered through the National Nurses Honor Guard Coalition &#13;&#10;by emailing the coalition president at jmury581@gmail.com&#13;&#10;cost is approximately 65-75$ + shipping. &#13;&#10;&#13;&#10;Cape Closure will be a large eye and hook closure that the nurse will need to sew in themselves, these closures can be found at  Hobby Lobby, Michael’s, or Amazon-&#13;&#10;*(see Dritz covered eye and hook 767-1)*&#13;&#10;&#13;&#10;*Inflation has affected the prices of many items* If you are in need of assistance with purchasing your cape, cap or any other required items, please let any of the officers know through text or email and we will help find a solution.   &#13;&#10;&#13;&#10;MEN&#13;&#10;● Men’s white uniform shirt&#13;&#10;● Men’s white nursing uniform pants&#13;&#10;● Men may wear white tennis shoes (all white only)&#13;&#10;● Men’s white under clothing and socks&#13;&#10;We look forward to you joining the West Tennessee Nurses Honor Guard.&#13;&#10;&#13;&#10;Please feel free to ask any questions!&#13;&#10;Email: westtnnurseshonorguard@gmail.com&#13;&#10;President: Linda Reid Billings----901-487-5192&#13;&#10;Vice President: Linda Kidd-------901-281-5535&#13;&#10;Treasurer: Lisa Monnin Kisling---731-676-5505&#13;&#10;Secretary: Jessica Clepper-------931-215-1167&#13;&#10;Digital Media: Rachael Schmidt--330-635-7408

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

County of Residence*

Date of Birth

Email Address*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Nursing License Number*

School of Nursing

Years of Nursing and any Specialties *

RetiredActive

T-shirt Size*

All New Members will receive a T-Shirt shortly after joining.

Are you a member of any other Nursing Honor Guard or Group? If so, which one(s)? Ie; VA Honor Guard*

Additional Comments or Questions