APPLICATION FOR ANAA MEMBERSHIP
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APPLICATION FOR ANAA MEMBERSHIP

Name: _____________________________Title: _______

Mailing Address: ________________________________

City: ___________________________ State: _________

Zip/Postal Code: ______________ Country: __________

Home Phone: ___________________________________

Business/Work Phone: __________________ Ext.______

Fax: _________________ E-mail: __________________

Credentials/Degrees/Dates_________________________

Professional Experience and Interests: _______________ ______________________________________________
Please continue on the reverse.

Member of the Anthroposophical Society?
 
 
  Yes, since: ______  
 
 
  No      

 

Charitable contribution for the development and education of anthroposophical nurses. ______________

 

General $100.00 ____________
Associate $85.00 ____________
Affiliate $85.00 ____________
Senior $70.00 ____________
Those over 60 years of age qualify for this reduced dues rate. Please circle whether you are a general, associate, or affiliate senior.

ANAA and its members also enjoy membership in Artemisia, an anthroposophical association of member organizations, professional groups and individuals seeking improvement in patient care through education, collaboration and collegial relationships.

Please submit your ANAA membership application to:

ANAA
5909 SE Division St.
Portland, OR 97206

Office Phone: 503 235 9067
Office Fax: 503 234 2367