Associate Member – Two Year Price: $150 for 2 years First Name:* First Name Required Last Name:* Last Name Required Address Line 1:* Address Line 1 is Required Address Line 2: Address Line 2 is not valid City:* City is Required Country:* Country is Required -- Select Country -- Afghanistan Åland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belau Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba CuraÇao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Republic of Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Martin (Dutch part) Saint Pierre and Miquelon Saint Vincent and the Grenadines San Marino São Tomé and Príncipe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (UK) United States (US) Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Western Samoa Yemen Zambia Zimbabwe State/Province:* State/Province is Required Zip/Postal Code:* Zip/Postal Code is Required salutation:* salutation is Required Mr.Mrs.Ms.Dr. professional_designation:* professional_designation is Required Home Phone:* Home Phone is Required Company: Company is not valid Work Address 1: Work Address 1 is not valid Work Address 2: Work Address 2 is not valid Work City: Work City is not valid Work Province: Work Province is not valid Work Postal Code: Work Postal Code is not valid Work Phone: Work Phone is not valid CNephC:* CNephC is Required YesNo CNA:* CNA is Required YesNo Member RNAO:* Member RNAO is Required YesNo Member ARNM:* Member ARNM is Required YesNo Member QIIQ:* Member QIIQ is Required YesNo Professional Status:* Professional Status is Required Registered NurseNurse PractitionerRegistered Practical Nurse/ Registered Nursing Assistant/ Licensed Practical NurseTechnicianTechnologistOther (please specify) Professional Status Other: Professional Status Other is not valid Number Years Nephrology: Number Years Nephrology is not valid Area of Responsibility: Area of Responsibility is not valid Area of Responsibility Other: Area of Responsibility Other is not valid Work Environment: Work Environment is not valid Level of Education Nursing: Level of Education Nursing is not valid DiplomaBaccalaureateMastersDoctorateN/A Level of Education nonNursing: Level of Education nonNursing is not valid Specialty CertificateBaccalaureateMastersDoctorateN/A Primary Area of Practice: Primary Area of Practice is not valid PediatricAdultCombined Adults/PediatricsOther (Please Specify) Consent Name Address:* Consent Name Address is Required YesNo Consent Email:* Consent Email is Required YesNo Username:* Invalid Username Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Have a coupon? Coupon Code: Invalid Coupon Please fix the errors above