Member of


Joint-Membership Application/ Renewal

Contact Information

Mailing Address:
Postal Code:
Telephone # (Primary) Home Work Cell
Telephone # (Alternative) Home Work Cell
Membership Type:
Full Member- $65.00/year: RN (Registered Nurse)
RPN (Registered Psychiatric Nurse)
LPN (Licensed Practical Nurse)

Student Member- $32.50/year: Student RN
Student RPN
Student LPN

Affiliate Member:
Health Care Assistant
Allied Health
Work Area: Residential
Acute Care
Educational Institution:
CNA Gerontological Nurse Certification GNC(C) No Yes Year
Which local chapter do you wish to belong to:

IMPORTANT:Please check where chapter meets under Chapter Information on website: before selecting chapter, as chapter names do not always indicate the geographic location where they hold their meetings

Geographic location:
Registration/payment using PayPal
Registration/payment by mail to GNABC business address ---> Print this completed form, make cheque payable to GNABC and mail to:
GNABC 328 Nootka Street, New Westminster, BC V3L 4X4 Canada
Registration/payment by cheque available in person, e.g. chapter meeting, conference ----> make cheque payable to GNABC.
For any questions, please email:
GNABC respects your personal privacy. We strive to protect any personal information you give us (address, name, email etc.). Your personal information is collected for the sole use of GNABC. Your personal information is not lent or sold to anyone for any purpose