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Global Society For Philippine Nurser Researchers, Inc.: Membership Application Form

Aura Bautista Bernardino is applying for professional membership in the Global Society for Philippine Nurser Researchers. She is currently an instructor at Nueva Ecija University of Science and Technology. She has a BSN and MA in Nursing. Her area of interest is nursing education and she is interested in both being mentored and mentoring others in research. She is paying the 500 PHP fee for a 1-year professional membership by depositing funds in the specified bank account.

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Cecille Alday
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142 views2 pages

Global Society For Philippine Nurser Researchers, Inc.: Membership Application Form

Aura Bautista Bernardino is applying for professional membership in the Global Society for Philippine Nurser Researchers. She is currently an instructor at Nueva Ecija University of Science and Technology. She has a BSN and MA in Nursing. Her area of interest is nursing education and she is interested in both being mentored and mentoring others in research. She is paying the 500 PHP fee for a 1-year professional membership by depositing funds in the specified bank account.

Uploaded by

Cecille Alday
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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GLOBAL SOCIETY FOR PHILIPPINE NURSER RESEARCHERS, INC.

Membership Application Form


PERSONAL INFORMATION
Title: Dr. [ ] Prof. [ ] Mr. [ ] Ms. [ /] Gender: Male [ ] Female [/ ]
Last Name: BAUTISTAMiddle Initial: BERNARDINO First Name: AURAPHEL
Affiliated Organization/ Institution: Nueva Ecija University of Science and Technology

Current Position: Instructor I

Mailing Address: , Cabanatuan City

City: Cabanatuan City


Contact Number: Landline: N/A Cellphone: 09227670557
Email address/es: aubernardino27@gmail.com

TYPE OF MEMBERSHIP
Student — for those who finished the course Nursing Research or currently taking the course
[/ ] Professional — registered nurse [ ] Associate — allied health professional
Bachelor's Degree: [ /] BSN [ ] Others:

Year Graduated: 2007

School: WESLEYAN UNIVERSITY OF THE PHILIPPINES

Other post-graduate degree: Master of Arts in Nursing


Year Graduated:2010 School: WESLEYAN UNIVERSITY OF THE PHILIPPINES

PRC license number: 0437766 Validity (Year of Expiry): 2025


Major area of activity: [ /] Education [ ] Practice (Clinical / Public Health)[ ] Others
Are you interested to be mentored for research? [/ ] Yes
[ ] No If yes, in which area of specialization:
[/ ] nursing education [ ] adult health nursing [ ] nursing leadership and management [ ] mother and child
nursing [ ] psychiatric nursing [ ] others:
Are you interested to be a mentor in research? [/ ] Yes
[ ] No If yes, in which area of specialization:
[ /] nursing education [ ] adult health nursing [ ] nursing leadership and management [ ] mother and
child nursing [ ] psychiatric nursing [ ] others:

Are you a member of a research cell? [ ] Yes, specify: [/ ] No


MEMBERSHIP PAYMENT
Validity
Categories of Membership
1 year 2 years 3 years
Professional [/] Php 500 [ ] Php 1,000 [ ] Php
1,500
Student [ ] Php 100
Associate [ ] Php 1000
For membership payments, kindly deposit to Philippine Nursing Research Society RCBC Savings Bank (Taft
Remedios Branch) Account No: 7590-674357. Submit the documentary evidence (i.e. scanned copy of deposit slip
or screen-captured successful electronic bank transfer) to the PNRS' official email (pnrsi.membership@qmail.com
Secretary's email (abiaa@hau.edu.ph), and Treasurer's email (pearled.cuevas@gmail.com) indicating the member's
name and corresponding category of membership, with email subject "PNRS MEMBERSHIP"

The annual fee for membership follows the calendar year. Only one person should apply per form.

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