Membership Registration | National Association of Nigeria Nurses And Midwives (NANNM)

PERSONAL INFORMATION:
1. Code:
2. Username*
3. First Name*
4. Last Name*
5. Nickname
6. Gender*
- Male
- Female
7. Date of Birth:
CONTACT INFORMATION:
8. E-mail*
9. Phone* Required phone number format: ###########
ABOUT YOURSELF:
10. Place Of Assignment:*
11. State:*
12. Local Government Area:*
13. Permanent Address:*
14. Old NANNM Card Number:*
15. Nursing & Midwifery Council (RN License Number):*
16. Nursing & Midwifery Council (RM License Number):*
17. Date of Employment:*
18. Years of Experience:*
19. Expected Year of Retirement:*
20. Add Qualifications/Years:*
21. Areas of Specialization:*
22. Capacity Building (Workshops/Seminars with dates)*
23. Upload Passport Photo:*Upload
24. Password* Minimum length of 8 characters.
The password must have a minimum strength of Medium.Strength indicator
25. Repeat Password*
26. Check reCaptcha:*

Membership Registration Form

No items found.