membership form

MEMBERSHIP INFORMATION
& offline application
(fill out and submit this form both if you have paid via credit card or plan to join offline)

ACTIVE: (FEE: $100/year) A licensed nurse who holds NCBTMB certification or a state license to practice therapeutic massage/bodywork, or has completed a minimum of 500 hours verifiable instruction in massage and/or bodyworks. Please enclose proof of status.

STUDENT: (FEE: $55/year) One of the following applies: a� licensed nurse enrolled in a massage therapy/bodywork program which will quality him/her to take a state massage licensing exam or the NCBTMB exam; a nurse massage therapist enrolled in a graduate level nursing program; a practicing massage therapist who is enrolled in an accredited school of nursing. Please enclose proof of enrollment from your education program.

INSTITUTIONAL MEMBER: (FEE: $300/year) A university, college or school of nursing or massage therapy, corporation, or individual business� supporting NANMTs goals and mission. Benefits: discounted advertising and exhibit space at conferences.

SUPPORTING MEMBER: (FEE: $75/year) An individual interested in supporting NANMT philosophy and goals.

SENIOR MEMBER: (FEE: $65/year) An individual age 65 or over.

(Only ACTIVE member category has a vote.)

APPLICATION FORM

Fill out the following, hit the SUBMIT button, and if you haven't paid via credit card, send your check or money order to:

NANMT
28 Lowry Drive
P.O. Box 232
West Milton, OH 45383

Your name:

Street address:

City:

State:

Zip code:

Home phone:

Work phone:

FAX:

Nursing license #:

States licensed in:

LMT/CMT license #:

e-mail address:

Nursing specialties:

Massage/bodywork specialties:

Check all that apply to you:
this is a renewal this is a new membership application

RN LPN/LVN LMT CMT

Type of membership you are applying for:

ACTIVE STUDENT INDIVIDUAL SUPPORTING CORPORATE SUPPORTING SENIOR

CHECK ONE:

Upon payment of my membership dues, I do do not want my information included in the NANMT membership directory.

(I testify that all information supplied on this application form is true and correct. I understand that I am responsible for notifying NANMT within 30 days should any changes in information occur.)

NANMT brochure in pdf format

MEMBERSHIP BENEFITS

professional support and affiliation with Nurse Massage Therapists nationally and internationally
listing in and access to the online member directory
subscription to the NANMT Bulletin
membership certificate and card
use of NANMT membership seal on stationery, business cards, and/or other promotional literature (for ACTIVE members only)
discounts on CEU courses for nursing and/or massage therapy
discounts on Standards of Practice for the Nurse Massage Therapist, National Coventions/Conferences
tax deduction of membership dues

JOIN TODAY!

1-800-262-4017