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MoSALPN Student Membership Application

Membership details

Dear Student,

MoSALPN is the Association for the Licensed Practical Nurse. For $25.00 you will be a member, the year you are in school and for 1 year following your graduation.

MoSALPN is the voice for the Licensed Practical Nurse with other health care groups, Associations, and/or Organizations.

MoSALPN has a Legislative Consultant at the State Capitol monitoring Legislative activities that might have a positive or adverse effect upon the profession of nursing.

MoSALPN welcomes you!

To join MoSALPN, print this page and send with payment to:

MoSALPN
PO Box 105542
Jefferson City, MO 65110



Student Membership Application

Name __________________________________________________

Address ________________________________________________

City, State, ZIP ___________________________________________

School in which you are enrolled:______________________________

Date Started: _______________ Graduation Date: ________________

Coordinator: _____________________________________________

Signature of Applicant: ______________________________________


LPN Student Membership Fee: $25.00 (two year membership)

I have enclosed my: _____ Check _____ Money Order