Membership Application
First Name
Date
Last name
Address
City
State, zip code
If you are a nurse what is your degree
RN
BSN
MSN
PhD
If a student what block/year & school
BLK 1&2
BLK 3&4
Frosh
Soph
JR
SR
N/A
2007
2008
2009
2010
2011 & beyond
Anticipated year of graduation
N/A
ASU
Ethel Bower
Abrazo Institute
Hospital based MCCC
MCCC all campus
Grand Canyon University
University of Phx
NAU
All other
What nursing school do you attend?
Are you a monitor Tech or EKG Tech?
Yes
No
N/A
Yes
No
Are you certified?
Email address
alternate email address
Please note: We notify members via email of
upcoming events and items of interest. Please
remove any blocks on your email for this address.
Indicate which email address you prefer us to use
by checking the box next to the address.
Are you interested in serving on a
committee?
Yes
No
Please complete the above membership application and push submit when completed.
Then push on the appropriate paypal button to pay the annual membership dues. Your
application will not be considered active until we are in receipt of your payment. Annual
dues are as follows: Licensed Nurses $75.00, Student Nurses (non licensed, attending
an Accredited nursing program) $45.00, Monitor technicians and EKG technicians
$69.00. Join today and start enjoying your membership benefits.
Annual dues Nurse $75.00
Annual dues Student Nurse $45.00
Monitor/EKG/CV tech annual dues:
$69.00
For questions
regarding membership
please contact our
Membership Director,
Linda Reynolds, RN
lreynolds@vosaccn.com
MEMBER BENEFITS
Networking
Monthly newsletter
Free continuing educational
credits for nurses
Monthly Educational venues free
of charge for members
Discounts on national and local
seminars
Membership in a
nationally
recognized cardiovascular
organization
Discounted educational materials
And much more......