San Diego Black Nurses Association, Inc.

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Member Application

Please be advised:

All unlicensed students must also submit a letter on their nursing school stationary, signed by the Nursing Administration. This letter will be forward to the National Office with the membership application. The student must be currently enrolled and does not have a LPN/LVN or RN license.

Joining a local chapter:

You must join a local Chapter and the National organization to be a member in good standing. The Chapter information and breakdown is on the SDBNA website: sdblacknurses.org. All Fees are Non-Refundable.

* Membership Type:

* Nursing Credentials

Please enter Nursing license number

* First

* Last

* Email

* Address

* City

* State

* Zip

* Phone

* Best Time to Call You If necessary, when is the best time for us to reach you via telephone?

Update Member Profile

* Experience in Nursing

* Nurse Profile

ANA Certified
Specialist (RN, CS)
Generalist (RN, C)
Prescriptive Authority

* Sex

Female
Male

* Level of Care Provided

In-patient
Public Health Department
Residential
Out-patient Ambulatory
Nursing Home
Rehabilitative

* Highest Degree Held

Associate Degree
Baccalaureate in Nursing
Masters in Nursing
Doctorate in Nursing
Diploma
Other Baccalaureate
Other Masters
Other Doctorate

* Nursing Employment

Full-time
Part-time
Unemployed
Retired

IMPORTANT NOTE:

Your responses to the following remain confidential and will only be used in the aggregate for membership profiles. All Fees are Non-Refundable.

* Annual Salary

Under $20,000
$20,000 - $29,000
$30,000 - $39,999
$40,000 - $49,999
$50,000 - $59,999
$60,000 - $69,999
$70,000 - $79,999
$80,000 plus

* Acceptance

I agree to the Terms of this Application

Your application will remain in the pending status until payment has been received and the application is reviewed. You may pay online with: PayPal, credit card or mail your payment to: SDBNA, PO Box 740088, San Diego, CA 92174-008