Individual Activity Application Submission Portal

Individual Activity Application (IAA) Submission Portal
Please submit your Individual Activity Application as a PDF utilizing the most up-to-date application template, which can be downloaded here. If you are not using the most current application template, you will be required to resubmit.
Full Name:*

First NameLast Name
Email Address:*
So that we can get back to you
Preferred Phone Number:*
Organization Name:*
Title of Individual Activity:*
Number of contact hours:*
Date of Activity (if enduring, enter start date, followed by "enduring"):*
If your activity start date is less than 30 days from application submission you will need approval from VNA to submit. Contact khildreth@virginianurses.org with questions.
Submit the completed Individual Activity Application and associated documents here: *

You can upload any type of file.
Cancelof

Payment Details
Please submit your credit card payment below or check the box to indicate that you have sent a check. Checks should be mailed to: Attn: VNA Accredited Approval Unit IAA Payment, Virginia Nurses Association, PO Box 13619, Richmond, VA 23225.

To calculate the total amount due, please visit our fees page.
I will submit my payment via:*

CheckCredit Card
Please note: Your application is not considered complete without payment in full. Application processing time does not start until you have paid, regardless of payment method.
Are you a VNA Organizational Affiliate?*

YesNo
If you selected yes to being a VNA Organizational Affiliate, you will be invoiced electronically with the discount code applied.

Individual Activity Application (IAA) Submission Portal