JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
CBNA-YorkU Membership Form
Sign up to become a member of Canadian Black Nurses Alliance- York University (CBNA-YorkU)
Sign in to Google
to save your progress.
Learn more
* Indicates required question
YorkU Email Address
*
Your answer
Name (First, Last)
*
Your answer
Student Number
*
Your answer
Nursing Program
*
4-Year Direct Entry Nursing Program
Collaborative Nursing Program
Second Entry Nursing Program
Internationally Educated Nursing Program
Year in Program
*
Year 1
Year 2
Year 3
Year 4
Are you interested in becoming a part of the team. If yes, please indicate and someone from the team will reach out to you.
*
Outreach Ambassador
Events team member
Marketing team member
No. I will be a general member
If you have any questions or concerns, please address below or reach us at cbna.yorku@gmail.com
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
