Membership Form

PHILIPPINE NURSES ASSOCIATION OF AMERICA, INC.

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*Additional Chapter Fees are separate from your national dues; please see next page.*

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Active Member (1 year) - $50.00 (USD) Subscription period: 1 year Automatic renewal (recurring payments)

Active Member (2 Years) - $100.00 (USD) Subscription period: 2 years No automatically recurring payments

Associate Member (1 Year) - $50.00 (USD) Subscription period: 1 year No automatically recurring payments

Associate Member (2 Years) - $100.00 (USD) Subscription period: 2 years No automatically recurring payments

Member-at-Large (1 year) - $50.00 (USD) Subscription period: 1 year No automatically recurring payments

Undergrad Student Subscription period: 1 year No automatically recurring payments Any student actively enrolled in an accredited prelicensure Registered Nursing program.

*Payment Transactions are via Wild Apricot /Affinipay, a safe and secured mode of on-line payment.*

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