SGNA FUJI Emerald Member Application Facility Information Facility Name Primary Contact Person Email Address Address Address Cont. City State Zip SGNA Membership Roster Member Info Position Select One 1. First Name: Nurse Manager Associates Program Staff Nurse/LPN Advanced Associates Last Name: Associate/Technician Program Email: 2. First Name: Nurse Manager Associates Program Staff Nurse/LPN Advanced Associates Last Name: Associate/Technician Program Email: 3. First Name: Manager Associates Program Staff Nurse/LPN Advanced Associates Last Name: Associate/Technician Program Email: 4. First Name: Nurse Manager Associates Program Staff Nurse/LPN Advanced Associates Last Name: Associate/Technician Program Email: 5. First Name: Manager Associates Program Staff Nurse/LPN Advanced Associates Last Name: Associate/Technician Program Email: 6. First Name: Nurse Manager Associates Program Staff Nurse/LPN Advanced Associates Last Name: Associate/Technician Program Email: 7. First Name: Nurse Manager Associates Program Staff Nurse/LPN Advanced Associates Last Name: Associate/Technician Program Email: Once the application is processed all members on this roster will receive an email with their username and password, and instruction on how to access all their benefits.
SGNA FUJI Emerald Member Application Facility Information Facility Name Primary Contact Person Email Address Address Address Cont. City State Zip SGNA Membership Roster Member Info Position Select One 1. First Name: Last Name: Email: Nurse Manager Staff Nurse/LPN Associate/Technician Associates Program Advanced Associates Program 2. First Name: Last Name: Email: Nurse Manager Staff Nurse/LPN Associate/Technician Associates Program Advanced Associates Program 3. First Name: Last Name: Email: Manager Staff Nurse/LPN Associate/Technician Associates Program Advanced Associates Program 4. First Name: Last Name: Email: Nurse Manager Staff Nurse/LPN Associate/Technician Associates Program Advanced Associates Program 5. First Name: Last Name: Email: Manager Staff Nurse/LPN Associate/Technician Associates Program Advanced Associates Program 6. First Name: Last Name: Email: Nurse Manager Staff Nurse/LPN Associate/Technician Associates Program Advanced Associates Program 7. First Name: Last Name: Email: Nurse Manager Staff Nurse/LPN Associate/Technician Associates Program Advanced Associates Program Once the application is processed all members on this roster will receive an email with their username and password, and instruction on how to access all their benefits.
Emerald%20Member%20Application_Final.docx