SUFFOLK COUNTY ASSOCIATION OF SCHOOL NURSES
SCASN
Healthy Children Make Better Learners
School Nurses Make It Happen

New: __________ Renewal:__________ Date:__________

 Name:____________________________________________________________________________

Please Print Last name First

Home Address: ___________________________________________________________________

City: ______________________________________ State:___________ Zip: __________

Phone(H): _______________ (W): _______________ (Fax): _______________

E-Mail: (H) ___________________________________ (W) ___________________________________
 
Work Address: ___________________________________________________________________

City: ______________________________________ State:___________ Zip: __________

Memberships: NYSASN:_________NASN: __________ Union (Name): ______________________ Other: __________

Please make your check for $20.00 payable to: Suffolk County Association of School Nurses
Membership is September to August.
Current members will receive mailings and a membership card.
Mail payment to:
Noreen Maynes - membership

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