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ADDRESS INFO
Membership Type *
Active Membership ($75.00) (only registered nurses from clinical practice or research setting are eligible) Active Membership (2 Year) ($135.00) (reduced-rate for 2-year membership only registered nurses from clinical practice or research setting are eligible) Student Membership ($35.00) (only full-time students eligible) Student Membership (2 Year) ($50.00) (reduced-rate for 2-year membership only full-time students eligible) Associate Membership ($50.00) (only non-RN healthcare professionals (e.g. MAs) are eligible) Associate Membership (2 Years) ($85.00) (reduced-rate for 2-year membership only non-RN healthcare professionals (e.g. MAs) are eligible) Sustaining Member ($85.00) (RNs from non clinical or research setting such as professional organizations, biopharmaceutical corporations, associations, other entities or individuals interested in financially supporting the Corporation) Sustaining Member (2 Years) ($145.00) (reduced-rate 2-year membership RNs from non clinical or research setting such as professional organizations, biopharmaceutical corporations, associations, other entities or individuals interested in financially supporting the Corporation )
Payment Type
Payment System *	Check Payment Credit Card (Visa / Mastercard Only)
Your Information
Name * Your First & Last name
E-Mail Address * A confirmation email will be sent to you at this address
Choose a Password * Must be 4 or more characters
Confirm your Password * Re-enter Password
Ms.,Mrs.,Mr. *	Ms. Mrs. Mr.
Mailing Address
Address *
City *
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ZIP *
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Institution / Organization
Phone
Fax
Educational Information
Nursing	Certification Diploma Associate Bachelors Masters Doctorate
Other Degree Field	Certification Diploma Associate Bachelors Masters Doctorate
Enrollment Status	Full Time Part Time
Program	Certification Associate Bachelors Masters Doctorate
Career Experience
Number of years experience in:	Nursing * Rheumatology *
Current License Status
License Status	LVN/LPN RN CNA Medical Assistant / Tech Other
Professional Information
Primary Work Setting	Hospital-Based Practice University-Based Practice Solo Practice Physician Office Group Rheumatology Practice Group Multi-Specialty Practice Outpatient Infusion Center Home Health Care Other

Primary Position	Clinical Research Coordinator Clinical Trial Nurse Nurse Coordinator Nurse Manager Clinical Manager Practice Manager Infusion Nurse Manager Infusion Nurse Staff Nurse Medical Assistant Assistant Director Director VP Nurse Practitioner Other

Employment Status	Per Diem Part-Time Full-Time Retired/Unemployed

Primary Patient Setting	Adult Pediatric Both

Primary Functional Area	Administration Patient Care Education Research Other
Biographical Data (Optional)
RNS is requesting biographical information from our membership to respond to the growing need for overall data. Responses to questions are optional.
Age	20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 Over 69

Sex	Male Female

Individual Salary Range	$20-29k $30-39k $40-49k $50-59k $60-69K $70-79k $80-89k $90k and Above

Ethnic / Racial Background	Black/African American American Indian/Alaska Native Asian or Pacific Islander White (Non-Hispanic, Asian, or Pacific Islander) Hispanic Other