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The World Federation of Critical Care Nurses

INVITATION FOR MEMBERSHIP

This below Application Form is designed to simply get your organisation registered with the WFCCN and to initiate dialogue with your official delegate to the WFCCN.

Please complete the Online Application Form below.

Step 1. Your details

Username^*

Password^*

Password must be at least 7 characters long.

Enter password again^*

Step 1. Your details

Step 2. Documents

Step 3. Consent

Organisation^*

Website^*

Address^*

City/Town^*

State^*

Postal/Zip Code^*

Country^*

Telephone No.^*

Fax No.

Contact Person^*

Contact’s Position^*

Email^*

Step 2. Documents

Step 1. Your details

Step 2. Documents

Step 3. Consent

Supporting Documents

Please submit a copy of the following documents listed below with your application. Acceptable formats include .doc, .pdf. (Please label your documents accordingly e.g. MissionStatement)

1. Mission and Vision statements of your organisation

Mission-Vision

I prefer to send my attachment at a later date

2. Constitution of your Organisation, Date by Laws

Constitution

I prefer to send my attachment at a later date

3. Names and Address of Board members (min 3 members required)

Board-members

I prefer to send my attachment at a later date

4. Recent newsletter(s), education materials (i.e pamphlets, brochures etc). Optional.

newsletters

I prefer to send my attachment at a later date

Explanation of attachments, if required

(Note: New, small and/or local organisations applying for membership may be reviewed with less documentation. Membership Committee will determine if sufficient information has been received. Please send any documents and information available. It is to your advantage that the Committee gets as complete a picture of your organisation as possible.)

How many members belong to your organisation?

# members

Actual
Estimate

What percentage/number are critical care nurses?

# nurses

Actual
Estimate

Step 3. Consent

Step 1. Your details

Step 2. Documents

Step 3. Consent

Consent and Submission

To the best of my ability, I have provided the most accurate and current information available to me, at the time of completing this application form. Through my position, I have authority to apply for membership to the WFCCN on behalf of the organisation I represent.

Name^*

Position^*

Organisation^*

Step 1. Your details

Step 2. Documents

Step 3. Consent

Organisation^*

Website^*

Address^*

City/Town^*

State^*

Postal/Zip Code^*

Country^*

Telephone No.^*

Fax No.

Contact Person^*

Contact's Position^*

Email^*

Step 2. Documents

Step 1. Your details

Step 2. Documents

Step 3. Consent

Supporting Documents

Please submit a copy of the following documents listed below with your application. Acceptable formats include .doc, .pdf. (Please label your documents accordingly e.g. MissionStatement)

1. Mission and Vision statements of your organisation

Mission-Vision

I prefer to send my attachment at a later date

2. Constitution of your Organisation, Date by Laws

Constitution

I prefer to send my attachment at a later date

3. Names and Address of Board members (min 3 members required)

Board-members

I prefer to send my attachment at a later date

4. Recent newsletter(s), education materials (i.e pamphlets, brochures etc). Optional.

newsletters

I prefer to send my attachment at a later date

Explanation of attachments, if required

(Note: New, small and/or local organisations applying for membership may be reviewed with less documentation. Membership Committee will determine if sufficient information has been received. Please send any documents and information available. It is to your advantage that the Committee gets as complete a picture of your organisation as possible.)

How many members belong to your organisation?

# members

Actual
Estimate

What percentage/number are critical care nurses?

# nurses

Actual
Estimate

Step 3. Consent

Step 1. Your details

Step 2. Documents

Step 3. Consent

Consent and Submission

To the best of my ability, I have provided the most accurate and current information available to me, at the time of completing this application form. Through my position, I have authority to apply for membership to the WFCCN on behalf of the organisation I represent.

Name^*

Position^*

Organisation^*

The World Federation of Critical Care Nurses

INVITATION FOR MEMBERSHIP

About WFCCN

Donations

Contact

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The World Federation of Critical Care Nurses

INVITATION FOR MEMBERSHIP

About WFCCN

Donations

Contact