West Virginia Nurses Association

West Virginia Nurse Newsletter

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Click here - Vol. 11, Number 4

APN Application

Online Contribution

West Virginia Nurses Association
405 Capitol Street, Suite 600 Charleston, WV 25301

Phone: 304.342.1169
Toll Free: 1.800.400.1226
Fax: 304.414.3369

centraloffice@wvnurses.org

State Only Membership Application

Online Application

Please fill out entire form before submission.

Contact Information

Full Name:
Credentials:
Today's Date: mm/dd/yyyy
Mailing Address:
City:
State:
Zip:
Home Phone:
Email:

Personal Information

RN License #:
Years Experience:
Basic School of Nursing:
District:
County of Residence:
NOTE: Please indicate the WVNA member who helped with your decision to become a member:

Employer Information

Employer:
Position:
Department or Division:
Mailing Address:
City:
State:
Zip:
Employer Phone:
Email:

Annual Dues: $149.00 or $12.52 monthly
Advanced Practice Council
Join the WVNA APN Council. For an additional $25 you can join this WVNA specialty group. An additional $25 check should be made payable to WVNA
I would like to join the APN Council
WV Nurses-Political Action Committee
Join the external political action committee for nurses. An additional $25 check should be made payable to WVN-PAC.
I would like to join the WVN-PAC

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