2025 Convention - Individual Registration Form

2024 MNSA Annual Convention Individual Registration Form

Nursing Unlimited: Beyond the Bedside
Full Name*

First NameLast Name
Preferred Name
School you are representing*
E-mail (Please use school email for students & faculty)*
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Information (this info will not be shared & only used if you have a medical emergency during the convention)

First NameLast Name
Phone Number

Area CodePhone Number
This is going to be a great, action packed day filled with amazing speakers and exhibitors! We have worked REALLY hard to make this convention FREE for all attendees. We understand emergencies happen, please notify us right away if you can not attend due to an emergency. To minimize waste and cut down on costs PLEASE notify us at least 10 days in advance if you register & can no longer attend for nonemergent reasons. We are counting on all of you to help make us better, we hope this convention helps to show you how far we've come!
Attendee Information*

MNSA/NSNA MemberSchool Delegate, please mark if yes (Check with your school faculty if unsure)RN StudentLPN StudentNew GradFaculty/StaffOther
MNSA/NSNA Member Number
Can be found on your NSNA Member Card or NSNA Online Account
Are you on your school SNA's Board of Directors?
Please list School SNA Position if applicable
Graduation Date (Required for students, N/A for faculty/staff
Please include Month/Year
Are you interested in being on the MNSA Board of Directors?
Please list position(s) of interest
Is this your first MNSA Annual Convention?

YesNo
How Did You Hear About This Convention?

MNSA NewsletterInstagramFacebookE-MailFaculty/StaffProfessional OrganizationOther
Would you like to receive emails from our exhibitors including hiring events, open positions, special discounts, and information to further your nursing degree

Opt-inOpt-out
Do You Have Any Dietary Restrictions (Vegan; Vegetarian; GF) or Food Allergies ? If So Please List
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2024 MNSA Annual Convention Individual Registration Form