37th PNAA Convention Registration

REGISTRATION IS CLOSED

See you in WASHINGTON, DC!

REGISTRATION FORM

Full Name *

First Name Last Name

E-mail *

Sex

Female Male

Mobile Phone Number *

- Area Code Phone Number

Current PNAA Member

Yes No

Chapter *

RN License #

First Time Attendee

Yes No

Region

Eastern Western South Central North Central

Address *

Zumbathon $30 - sign up at Zumbathon website click link: Kintera.org

Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.

7/22/16 4:00pm - 4:45pm

APRN Forum

to sign up, e-mail Ms. Luz Newell: luznewell1@aol.com

Convention Options

07/21/16 Leadership Institute - Additional Delegate $ 75.00

07/21/16 Leadership Institute - Student (taking UnderGrad. Nursing/not a licensed RN yet) MUST SHOW PROOF $ 50.00

07/21/16 Leadership Institute - Free

07/21/16 BY INVITATION ONLY NIH Research Workshop REQUIRES CONFIRMATION FROM MARLON SARIA Free

07/21/16 White House Initiative on Asian Americans and Pacific Islanders Free

07/21/16 Networking Night $ 100.00

07/22/16 Education Day - Member $140 + Late Fee $50 $ 190.00

07/22/16 Education Day - Non-Member $160 + Late Fee $50 $ 210.00

07/22/16 Education Day - Student MUST SHOW PROOF $75 + Late Fee $50 $ 125.00

07/22/16 Education Day - Late Fee $ 50.00

07/22/16 Education Day - Exhibitor Free

07/22/16 Potomac River Cruise $ 92.00

07/24/16 Mass Free

Subtotal $ 0.00 Tax $ 0.00 Total $ 0.00

Payment Method