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Serve the Great Physician
TODAY in Alabama BNF
BNF Membership Application: Print, complete and mail this form to:
Alabama Baptist Nursing Fellowship
PO Box 11870
Montgomery, AL 36111-0870
Enclose check for $30 membership fee, made payable to
"Alabama WMU"
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New Member |
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Renew My Membership |
| I am a (check all that apply.) |
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Registered Nurse |
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Licensed Practical Nurse |
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Student Nurse |
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Missionary Nurse |
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Retired Nurse |
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Other |
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Nurse Registration Number |
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Name
_____________________________________ Church Name/City
_____________________________________ |
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Specialty
______________________________________________________________________________________ |
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Mailing Address
_________________________________________________________________________________ |
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City/State/Zip ___________________________________________________________________________________ |
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Daytime
Phone (_______) _______________________Evening Phone (________)___________________ |
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E-Mail Address
__________________________________@____________________________________ |
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Fax Number (_______)
_______________________________________ |
| Education Level:
_____LPN/LVN ______RN ______BSN _______MS/MSN_______ Doctorate |
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