Membership Application


Fill out and submit the application here to become a member of HANA

If you would like to download a pdf version of the membership form, click here

new returning associate student


If you are an associate member, specify your interest


If you are a student, enter the name of your school here


If you are a student, enter the location of your school here

rn lpn np nurse_midwife other


if you selected other, please specify


Select All That Apply


Select All That Apply


Do you wish to be included in the Mailing List?

*Required

Nomination Application


Fill out and submit the application to nominate a member to a committee position

If you would like to download a pdf version of the nomination form, click here


name of proposed nominee


nominee's credentials


I am currently a member of HANA (non-members may not make a nomination)

nurse associate student


Enter other Comments or information

*Required

Claudette Colimon Memorial Scholarship


Fill out and submit the application here to apply for the Claudette Colimon Memorial Scholarship
To see if you are qualified for the the application, go to the About Us Section and view the scholarship criteria

If you would like to download a pdf version of the scholarship form, click here

Personal Data

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Choices was empty
Are you a US Citizen?


If applicable, please enter your professional nursing license


What language(s) do you speak?

LPN ADN BSN MSN Doctorate
What nursing degree are you pursuing


Community Involvement


Attach the essay that you want to submit with the application here

*Required

High School Senior Scholarship


Fill out and submit the application here to apply for a High School Senior Scholarship
To see if you are qualified for the the application, go to the About Us Section and view the scholarship criteria

If you would like to download a pdf version of the scholarship form, click here

Personal Data

No choices
Choices was empty
Are you a US Citizen?


If applicable, please enter your professional nursing license


What language(s) do you speak?

LPN ADN BSN
What nursing degree are you pursuing


Community Involvement


Attach the essay that you want to submit with the application here

*Required