test

AGM Registration

Required fields indicated by an asterisk (*).

Name*:
Registration #*: (Required only for CLPNNS members)

Email Address*:

Phone Number:

Mailing Address:

City:

Postal Code:

Electronic signature*:

* I verify that I am the CLPNNS member stated above and confirm that this counts as my electronic signature

captcha Please type the characters and/or digits you see in the box below.

Award Banquet & PD Day Registration


Name*:
Registration #*:

Registering for:

Mailing Address:

City:

Postal Code:

Phone Number*:

Email Address*:

Method of payment*:
CashChequeMoney OrderVisaMasterCard

If credit card, Card #

Expiry Month:
/ Year:

My registration fee is being paid by:
If "Other:"

Receipts should be made out to:
If "Other:"


Electronic signature*:

I verify that I am the CLPNNS member stated above and confirm that this counts as my electronic signature

captcha Please type the characters and/or digits you see in the box below.

Registration fees are non-refundable. Money orders should be made payable to the College of Licensed Practical Nurses of Nova Scotia (CLPNNS) using the mailing address below. Substitution is permitted.

Registration deadline: April 30, 2018.

AGM Resolutions Form


Whereas:

Whereas:

Be it resolved:

Explanatory Notes (if necessary):

Mover:

Mover's Registration Number:

Mover's Telephone Number:

Mover's E-mail Address:

Mover's electronic signature:

My signature verifies that I am the CLPNNS member in good standing as indicated by the information provided above.

Seconder

All resolutions require a seconder to support it. Please note that your seconder will be contacted with a copy of the resolution and will need to confirm their support.

Seconder's Name:

Seconder's Telephone Number:

Seconder's E-mail Address:


captcha Please type the characters and/or digits you see in the box below.