2017 Baptist Nursing Fellowship Online Membership Form

Baptist Nursing Fellowship •••••••••••••••••••••••••••••••

2017 Online Membership Form

Membership Information
Name *
Address: *
City: *
State: *
Zip: *
Country: *
Birthday: *

/ Month / Day Year
Date
Phone: *
Email:
BNF has a Member's Only web site where our membership directory is accessible for other BNF members. Is it okay to list the contact information above in this directory? *

Yes. It is okay to list my information. No. Please keep my information confidential.
Is this membership being given as a gift? *

Yes No
If yes, who is it given by?
Are you joining national BNF for the first time or is this membership a renewal? *

I am joining national BNF for the first time. I am renewing my national BNF membership.
How did you first learn about BNF? Please be as specific as possible. *
National BNF sends out a newsletter once a quarter, The Lamplighter. We like to feature new members in the newsletter. Would you be open to being featured in The Lamplighter?

Yes. You may contact me about a feature in The Lamplighter. No. I would prefer not to be featured in The Lamplighter.
Professional and Ministry Information
Specialty:
Educational Level *
Missionary: *
Profession *
Types of Personal Ministry that Interest You:
Church Name:
Membership Fees
Please indicate the profession and state/region in which you would like to join. Please note that several states do not currently have an active BNF; therefore they do not have state BNF fees. Please also note that each state BNF sets its own state fees, so there are different fees per state/region.
Registered Nurse
Licensed Practical Nurse
Other professional fields
Retired Nurse
Student Nurse
Missionary Nurse
Retired Missionary Nurse
Once you submit this form, you will automatically be redirected to an online payment page.

*If you are a Missionary Nurse or Retired Missionary Nurse, you can close out of the online payment page.
Should be Empty:

Membership Information

Professional and Ministry Information

Membership Fees