PA Developmental Disabilities Nurses Network
Connected Through Caring
MEMBERSHIP      
                         MEMBERSHIP FORM
Current dues:
 Individual-$30.00
 Group-5 or more $25.00 each
 Please complete (print)

Name _________________________________________
Licensure/Credentials ___________________________
Preferred Mailing Address _______________________
_______________________________________________
Is this home or work address? ____________________
Employer:______________________________________
Phone: ________________________________________
Email address:__________________________________

Amount enclosed: ____________________
Please check one of the following choices:
_______  send information via regular mail
_______  send information via email

Make checks payable to PADDNN

Print Form and Send to : 
                   Melody Wolf
                   315 Stanton Street
                   South Williamsport, PA 17702




                                            

On behalf of the officers of PADDNN, we would like to extend our invitation to join our membership.
PADDNN is the only organization in Pennsylvania that specifically supports developmental disabilities nursing and  we are seeking your support of this organization.
We are dependent on membership dues for our continued viability and growth.  Your financial support and active membership in PADDNN is greatly appreciated.  We look forward to continued growth in 2008, and we strive to be a resource for the latest updates in DD nursing, as well as an excellent opportunity for networking with colleagues across the state. 
Individual Membership fee is $30.00 annually. 
A discount is provided for Group membership.  Groups of 5 or more will be provided membership at $25.00 per nurse per annum.
Our membership year follows the calendar year and runs from January 1 through December 31st.

WE'D LOVE TO WELCOME YOU AS A NEW MEMBER OF THIS PROFESSIONAL NURSING ORGANIZATION IN 2008!!!


If you would like information regarding membership in the national Developmental Disabilities Nurses Association, please click the following link to their website...

http://
www.ddna.org
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