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membership meeting

TNA Membership Meeting
1:30pm – 3:30pm

Sheraton Downtown Nashville Hotel
623 Union St., Nashville
(615) 259-2000

Attention TNA Members

CALL TO MEET

WEDNESDAY, APRIL 4, 2001

Hear the Report on Organizational Restructuring

Delegates will vote at this meeting on TNA Restructuring

Let Your Voice Be Heard!

There is no registration fee, however, registration is required

Spring Health Policy Summit Registration
(Secure Form)

Please fill out the information below completely.
Any incomplete forms will not be processed

Your Information

Full Name
Name on Your Badge
Street Address
City State Zip
Work Phone Home Phone
Email Fax
RN License # Credentials
Nursing Specialty
Employer
TNA Member? Yes No
TNA Member ID or Social Security#
TNA Delegate? Yes No
Full Time Student? Yes No
Retiree? Yes? No

I would like to attend the Membership Meeting to vote on TNA Organizational Restructuring
(Must be a TNA Member). NO FEE REQUIRED

I would also like to attend:

Full Health Policy Summit
(includes Legislative Reception and Issues Lunch – 6.5 Contact Hours)
   Member ($115)
   Nonmember ($145)
   Full-time Student or Retiree ($85)

Health Policy Summit – Tuesday Only
(Includes Legislative Reception – 4.4 Contact Hours)
   Member ($75)
   Nonmember ($95)
   Full-time Student or Retiree ($55)

Health Policy Summit – Wednesday Only
(Includes Issues Luncheon – 2.1 Contact Hours)
   Member ($55)
   Nonmember ($75)
   Full-time Student or Retiree ($35)

Legislative Reception Only
(No Contact Hours)
Member, Nonmember, Student, or Retiree ($25)

Payment Method

Visa
Mastercard
Discover
American Express

Account Number (include no spaces or dashes)
Expiration Month Expiration Year

   Check: Please print this form and mail with a check payable to
   Tennessee Nurses Association to TNA, 545 Mainstream
   Dr., Ste. 405, Nashville, TN 37228.Your space will not
   be reserved until payment has been received.

Employer is sending payment: Please print this form and mail
   with the payment with check payable to Tennessee
   Nurses Association to TNA, 545 Mainstream Dr., Ste.
   405, Nashville, TN 37228. Your space will not be
   reserved until payment has been received.

Check this box if you require special auxilliary aids or services (e.g, vegetarian meals)
Please list them here