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NZUNS Membership
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Email
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Your email
First Name
*
Your answer
Last Name
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Your answer
Mobile number
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Your answer
Address
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Your answer
Application type
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New
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Region
*
Your answer
Employment Details
Hospital/ Institution name
*
Your answer
Facility type
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Position Title
*
Enrolled Nurse
Registered Nurse
Clinical Nurse Specialist
Nurse Practitioner
Employment type
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Full time
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Years in Urology
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Highest Education Attained
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The Privacy Act requires you to be made aware that the information collected on this form is required for administrative uses. You have the right to access and correct this information by contacting NZUNS.
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Bank Details for Direct Transfer
Membership subscription $100
Bank: ASB
Account Number: 12-3159-0150127-00
Account Name: NZ Urological Nurses Society Incorporated (NZUNS)
Please give: your first name, your surname and regional area
A copy of your responses will be emailed to the address you provided.
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