NLNRS Membership Form

I wish to renew my membership in (  ) or become a member of (  ) the Newfoundland & Labrador Nurses’ Respiratory Society.

Membership fee of $10.00 for one year.

Name: ___________________________________________________________________

Address: _________________________________________________________________

Postal Code: __________ Tel: (res)___________ (bus): _____________ (fax):___________

Place of Employment: _____________________________________________________

Position/Title:____________________________________________________________

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Please print, cut on dotted line, place in envelope and forward to :

The Newfoundland & Labrador Lung Association
P.O. Box 13457, Stn. A
St. John’s, NL A1B 4B8