Assisted Living Nurse Certification Exam Registration

I am not an AALNA member. Register me at the member rate of $375.00 + $5.00 credit card processing fee.

Price:

$383

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Date of Birth:* Date of Birth is Required

Title: Title is not valid

Company/Community Name: Company/Community Name is not valid

Highest Degree Completed: Highest Degree Completed is not valid

Nursing Credentials:* Nursing Credentials is Required

Nursing License Number:* Nursing License Number is Required

Phone Number:* Phone Number is Required

Nursing School Attended: Nursing School Attended is not valid

Date Graduated: Date Graduated is not valid

Graduate School Attended: Graduate School Attended is not valid

Date Graduated: Date Graduated is not valid

I certify under penalty of perjury, I have completed a minimum of 1,000 hours of nursing practice in a licensed assisted living/residential care community.*

Communities Attended: Communities Attended is not valid

Signature:* Signature is Required

Date:* Date is Required

By clicking on the *

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

No val Please fix the errors above

*Membership dues are non-refundable.

*Membership dues are for a one-year membership that expires 12 months from the date this application is processed. Renewal notices will be sent prior to expiration. Correspondence will be sent to the mailing and/or email address(es) provided above.

For AALNA Non-Members