School Nurse Summit Form:
Name: ______________________________________________________________________
  ____RN ____LPN ____APN ____ Other (specify)_____________________________
Address: ______________________________________________________________________
City: _______________________ State:______ Zip:_____________________________
Telephone: Day:___________________ Evening:______________________________________
Place of Employment: ______________________________________________________________

Non-member fee is $95. Please attach your check made payable to MNA. Send Registration forms to:
Massachusetts Nurses Association • 340 Turnpike Street • Canton, MA 02021
For more information, contact Dolores Neves, 781.830.5722 or 800.882.2056, x722 or email dneves@mnarn.org.