ONLINE NCF MEMBERSHIP RENEWAL (USA ONLY)

Use "tab" to move through the form - * indicates a must fill field

*First Name:

*Last Name:

*E-mail:

* MAILING ADDRESS (USA ONLY)

Street Address:

City: State: Zip:

Preferred Phone: Home Office Cell

CURRENT NURSING ROLE:

Student - School and year of graduation:
Staff Nurse
Faculty - School:
Administrator/Manager
Advanced Practice
Parish Nurse
Other

Fee: $65 for practicing nurses, $50 for retirees, $35 for full-time nursing students and $25 for full-time student JCN online-only access.

Pay Membership Online takes you to the Online Store for InterVarsity Christian Fellowship to process your payment. Be sure to select the option as you check out. Your shipping costs are included in your membership payment.

OR

Pay by mail (Print this page and mail with your check to Nurses Christian Fellowship, P.O. Box 7895, Madison, WI 53707-7895.)