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