ALASKA NURSES FOUNDATION Application for Membership Individual Membership Individual Member $20.00 Sustaining Member $50.00 Memorial Plaque TOTAL Name: Address: Phone: E-Mail: If Memorial Plaque contribution made, list name & information about individual being memorialized (examples below): Christina Mumma, RN, PhD Mia McDermott, RN, NNP Joyce Pospisil UAA Professor of Nursing Mother of Debbie Thompson Make check payable to Alaska Nurses Foundation and mail to Alaska Nurses Foundation, P. O. Box 244471, Anchorage, AK 99524-4471. Note: application should be e-mailed to
ALASKA NURSES FOUNDATION Application for Membership Individual Membership Individual Member $20.00 Sustaining Member $50.00 Memorial Plaque TOTAL Name: Address: Phone: E-Mail: If Memorial Plaque contribution made, list name & information about individual being memorialized (examples below): Christina Mumma, RN, PhD Mia McDermott, RN, NNP Joyce Pospisil UAA Professor of Nursing Mother of Debbie Thompson Make check payable to Alaska Nurses Foundation and mail to Alaska Nurses Foundation, P. O. Box 244471, Anchorage, AK 99524-4471. Note: application should be e-mailed to
2017%20Research%20Grant%20Application%20-%20PHNs.docx