ONLINE NCF MEMBERSHIP APPLICATION (USA only)

Use "tab" to move through the form.

First Name: *must fill field

Last Name: *must fill field

Credentials:

MAILING ADDRESS

Street Address: *must fill field

City: State: Zip: *must fill fields

Country: USA Addresses ONLY

Preferred Phone: Home Office Cell

E-mail: *must fill field

CURRENT NURSING ROLE: check boxes that apply

Student (School/year of graduation: )

Staff Nurse

Faculty (School: )

Administrator/Manager

Advanced Practice

Parish Nurse

Other

I am a current Journal of Christian Nursing (JCN) subscriber

I am in agreement with the NCF Purpose and Doctrinal Basis (*This box must be checked indicating agreement in order to process your membership application)

This is my first contact with NCF.

I have been involved with NCF in the past. Where?

I'm a former member.

I'm currently involved with NCF in my local area. Where?

MEMBER PARTNERSHIP:

• Membership Opportunities: (will be sent with Membership Card)
• I am in agreement with the NCF purpose and doctrinal basis
• The annual membership fee (US only) is $65 for practicing nurses, $50 for retirees, $35 for full-time nursing students and $25 for undergraduate student JCN online only access.
• Give gift to NCF ministry online

Pay Membership Online takes you to the Online Store for InterVarsity Christian Fellowship to process your payment. Your shipping costs are included in your membership payment, so as you check out please select the No shipping option .

OR

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