Name:                                                                           Credentials:
  
Position/Title:

Organization:

Organization Mailing Address:

City: 
    State:      Zip:
Organization Telephone:   Organization Fax:
       
E-Mail:
(required for reply)

BE SURE TO REVIEW THE DISTRICT MAP AND SELECT THE DISTRICT APPROPRIATE FOR
YOUR PLACE OF EMPLOYMENT
Please indicate your organizations district        Click here to view district map.
Do you currently belong to AONE? Yes No
Are you a member of any other professional organization?  Yes No

If yes, please list:

(Please Check One)
New Membership........... .........$100.00*
Renewal..................................$100.00*
Affiliate Membership.................$100.00**
Associate Membership.............$  50.00*
Honorary (Retired).....................No Fee
Organization Membership:  Purchase 5 memberships collectively,
                                             and receive 1 membership free

Donation to Nurse Leadership Recognition Program $

*Calendar year begins January 1st. New membership received after September 1st will carry through the new calendar year.

Make check/money order (credit cards not accepted), payable to MONE and send to:

MONE Member Services
Michigan Health & Hospital Association
6215 West St. Joseph Highway
Lansing, MI. 48917
Phone (517) 886-8367

Click here to application.                           

Click here to entire form.

*Associate Members shall be registered nurses who are students enrolled in a relevant degree program and not otherwise eligible for membership. They may attend MONE business and educational meetings but not be permitted to vote or hold office.

**Affiliate members of MONE shall be individuals who are not Registered Nurses but who support the mission and vision of MONE. They may attend MONE business and educational meetings, but will not be considered full members, not be permitted to vote in the meetings of, or hold office in or vote for, the directors or officers of the MONE.