*** You may not qualify for direct individual NAINA membership if there is an Indian Nurses Association in the state you are licensed and practicing. Please join the local association and you will automatically become a member of NAINA. ***
By virtue of individual membership in the local chapters or associations of Indian nurses in their respective states in the USA will automatically become members of NAINA, National Association of Indian Nurses of America.
Membership type (Check all that apply). New Member Membership Renewal Registered Nurse Pre-licensure Nursing Student Associate Member
Number / Street Name
Phone Number : Home
Phone Number : Cell
Phone Number : Work
Place of Employment
Area of Specialty
Ethnicity Asian Indian Asian Indian Descent Other (please specify)
Other (please specify)
Name of Basic Nursing School Education (Specify Country):
Basic Degree Received:
Year Graduated from Basic Nursing School (Example: 1995):
Highest Educational Attainment
Currently Enrolled in Higher Education:
State Licensed to Practice
Nursing Salary per Year
Total years of nursing experience
Total years of RN nursing experience in USA
Advanced Practice Nurses
Area of Nursing Focus/ Specialty
*** You may not qualify for direct individual NAINA membership if there is an Indian Nurses Association in the State you are licensed and practicing. Please join the local association and you will automatically become a member of NAINA.
To locate member Associations check our website.For student and affiliate membership fee, contact us at www.nainausa.com.
Life membership fees $200.00 (renewable every ten years)
Your signature below indicates that you are hereby agreeing to uphold the mission, vision and bylaws of NAINA.
Signature of the Prospective Member
OFFICIAL USE ONLY
Application/Fee Received On :
Membership Approved: YesNo
Name of the official
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