To join we need a completed application and membership dues for the first year.
Please contact us for more information, a copy of the application is below.
Bring your application form/dues to the next meeting (see Calendar of Events) or mail to :
MN MetroDDNA,
P.O. Box 7374,
St. Paul, MN. 55107
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MN METRO DDNA MEMBERSHIP APPLICATION
Enclosed payment is for Annual________ Individual dues of $25 or ________$100
group fee
Last Name__________________First Name________________
Preferred first name:_______Licensure ___RN ___LPN __RNC
Nursing License #______________ State Licensed in:_________
Employer:_________________________Title_______________
Work address:________________________________________
City:_________________State________Zip_________
Home address:________________________________________
City:________________State________Zip_________
Contact me at my ______home ______work ______either
Home phone:_________________________
Work phone:_________________________
E-Mail address:________________________________________
My phone or e-mail may be shared with members:___yes____no
MAKE CHECKS PAYABLE TO: MN Metro DDNA
All returned checks will be charged a $20 fee, all fees are non-refundable/non-transferable.
Date:__________________________Signature__________________________________
