Membership
fee: €20
Print this page out. Complete the application form enclosing
a cheque or postal order (cheques and postal orders should
be made payable to the Irish Diabetes Nurses Association)
for €20 and return to:
Siobhan Meehan
Diabetes nurse specialist,
Health centre,
Coosan rd,
Athlone
(Please
note that membership is open only to nurses working in the care of people with
diabetes) IRISH
DIABETES NURSE SPECIALIST ASSOCIATION
MEMBERSHIP APPLICATION FORM | Name:
Contact Address:
Place of Employment:
E-mail:
Work Phone:
Home
Phone:
Mobile Phone:
Do you work solely in Diabetes
Care?
Do you work with children, adults or both?
Are you involved in maternity care of woman with diabetes?
Signature:
Date:
For office use only:
Full member:
Associate
member:
ID number PAID:
DATE:
Next subscription due:
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