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2019 Application for the Power of Nursing FDW Training

2019 Application for the Power of Nursing Faculty Development Training

1. Name and Education History *This question is required.
2. Nursing School/Health Care Institution where you will implement The Power of Nursing *This question is required.
5. Professional Nursing Position *This question is required.
Professional Position (if more than one held concurrently)
6. Work Contact Information *This question is required.
7. Home Contact Information
8. Which is your preferred email? *This question is required.
9. How did you hear about The Power of Nursing? *This question is required.
11. When do you plan to implement The Power of Nursing at your nursing school? *This question is required.
CONTINUING EDUCATION CREDIT FOR NURSES: Provider approved by the California Board of Registered Nursing, Provider # 10064, for 27 Contact Hours. BRN continuing education credits are accepted by most state nursing boards; please verify with your state agency if you are outside of California.
CANCELLATION & REFUND POLICY: A deposit of $300 is due at time that your application is accepted. The balance is due by June 15, 2019. A full refund of deposit (less processing fee of $25) will be issued for cancellations on or BEFORE July 1. Cancellations after July 1 will forfeit deposit.