PAPAN -- Form
                  Honorary Member Nomination Form - Step One
Pennsylvania Assocaiation of PeriAnesthesia Nurses
   
                                  

            Honorary Membership Nomination Form

Step One:  To be completed by the nominator

I wish to nominate ____________________________ for Honorary Membership in The Pennsylvania Association of PeriAnesthesia Nurses (PAPAN).

Nominator's Name: ____________________________
Address:  _____________________________________
Telephone (H)_____________ (W) _______________

How has this person rendered distinguished or valuable service to Perianesthesia nursing especially through activities of the Pensylvania Association of PeriAnesthesia Nurses (PAPAN)?

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Complete this form and send to
Chairperson Membership
F. Blatchley
215 Front Street, Box 101
New Berlin, PA 17855

Info@papanonline.org

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