Minnesota Nurses Association Membership Application

Personal and Job Information

Personal Information
First Name*
Middle Name
Last Name*
Address*
City*
State*
ZIP*
Personal Email*
Cell Phone

(Necessary for access to Member Center)

By providing my phone number, I agree that MNA may use automated calling technologies and/or text message me on my cellular phone on a periodic basis. MNA will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Call or email MNA at 651-414-2800 or mnnurses@mnnurses.org to stop receiving messages, or simply respond STOP to any text message you receive to stop receiving future messages.

Job Information
Employer / Facility*
Specify Other Employer / Facility*
Job Type*
Employee Number
Unit / Department
Date of Hire
Shift / Rotation
FTE / Hours
Field of Employment