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    Global Society For Philippine Nurser Researchers, Inc.: Membership Application Form

    Uploaded by

    Cecille Alday
    - The document is a membership application form for the Global Society for Philippine Nurser Researchers that collects personal and professional information from applicants such as name, organization, education history, areas of research interest, and payment details. - The applicant, Rose Ann Paet, is an Instructor at Nueva Ecija University of Science and Technology who holds a BSN and MA in Nursing and is applying for a 1-year professional membership for Php 500. - Membership fees are to be deposited into the organization's bank account with deposit slip or transfer confirmation to be emailed to specified addresses for verification.

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    © All Rights Reserved
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    Global Society For Philippine Nurser Researchers, Inc.: Membership Application Form

    Uploaded by

    Cecille Alday
    48 views2 pages
    - The document is a membership application form for the Global Society for Philippine Nurser Researchers that collects personal and professional information from applicants such as name, organization, education history, areas of research interest, and payment details. - The applicant, Rose Ann Paet, is an Instructor at Nueva Ecija University of Science and Technology who holds a BSN and MA in Nursing and is applying for a 1-year professional membership for Php 500. - Membership fees are to be deposited into the organization's bank account with deposit slip or transfer confirmation to be emailed to specified addresses for verification.

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    - The document is a membership application form for the Global Society for Philippine Nurser Researchers that collects personal and professional information from applicants such as name, organization, education history, areas of research interest, and payment details. - The applicant, Rose Ann Paet, is an Instructor at Nueva Ecija University of Science and Technology who holds a BSN and MA in Nursing and is applying for a 1-year professional membership for Php 500. - Membership fees are to be deposited into the organization's bank account with deposit slip or transfer confirmation to be emailed to specified addresses for verification.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    48 views2 pages

    Global Society For Philippine Nurser Researchers, Inc.: Membership Application Form

    Uploaded by

    Cecille Alday
    - The document is a membership application form for the Global Society for Philippine Nurser Researchers that collects personal and professional information from applicants such as name, organization, education history, areas of research interest, and payment details. - The applicant, Rose Ann Paet, is an Instructor at Nueva Ecija University of Science and Technology who holds a BSN and MA in Nursing and is applying for a 1-year professional membership for Php 500. - Membership fees are to be deposited into the organization's bank account with deposit slip or transfer confirmation to be emailed to specified addresses for verification.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    GLOBAL SOCIETY FOR PHILIPPINE NURSER RESEARCHERS, INC.

    Membership Application Form


    PERSONAL INFORMATION
    Title: Dr. [ ] Prof. [ ] Mr. [ ] Ms. [/ ] Gender: Male [ ] Female [/ ]
    Last Name: PAET Middle Initial: RAZON First Name: ROSE ANN
    Affiliated Organization/ Institution: Nueva Ecija University of Science and Technology

    Current Position: Instructor I

    Mailing Address: 251 Purok # 3, Valle Cruz, Cabanatuan City

    City: Cabanatuan City


    Contact Number: Landline: N/A Cellphone: 09263318371
    Email address/es: ra.paet23@gmail.com

    TYPE OF MEMBERSHIP
    Student — for those who finished the course Nursing Research or currently taking the course
    [/ ] Professional — registered nurse [ ] Associate — allied health professional
    Bachelor's Degree: [ /] BSN [ ] Others:

    Year Graduated: 2011

    School: NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY

    Other post-graduate degree: Master of Arts in Nursing


    Year Graduated:2017 School: Dr. Gloria D. Lacson Foundation Colleges Inc.

    PRC license number: 0709282 Validity (Year of Expiry): 2026


    Major area of activity: [ /] Education [ ] Practice (Clinical / Public Health)[ ] Others
    Are you interested to be mentored for research? [/ ] Yes
    [ ] No If yes, in which area of specialization:
    [/ ] nursing education [ ] adult health nursing [ ] nursing leadership and management [ ] mother and child
    nursing [ ] psychiatric nursing [ ] others:
    Are you interested to be a mentor in research? [/ ] Yes
    [ ] No If yes, in which area of specialization:
    [ /] nursing education [ ] adult health nursing [ ] nursing leadership and management [ ] mother and
    child nursing [ ] psychiatric nursing [ ] others:

    Are you a member of a research cell? [ ] Yes, specify: [/ ] No


    MEMBERSHIP PAYMENT
    Validity
    Categories of Membership
    1 year 2 years 3 years
    Professional [/] Php 500 [ ] Php 1,000 [ ] Php
    1,500
    Student [ ] Php 100
    Associate [ ] Php 1000
    For membership payments, kindly deposit to Philippine Nursing Research Society RCBC Savings Bank (Taft
    Remedios Branch) Account No: 7590-674357. Submit the documentary evidence (i.e. scanned copy of deposit slip
    or screen-captured successful electronic bank transfer) to the PNRS' official email (pnrsi.membership@qmail.com
    Secretary's email (abiaa@hau.edu.ph), and Treasurer's email (pearled.cuevas@gmail.com) indicating the member's
    name and corresponding category of membership, with email subject "PNRS MEMBERSHIP"

    The annual fee for membership follows the calendar year. Only one person should apply per form.

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