NSNA CEO Appearance Request

NSNA CEO Appearance Request

Fill out this form to make a formal request to have the NSNA CEO have a presence at your upcoming event. Requests must be received one month before scheduled event.
Event:*
Date of Event:*

MonthDayYear
Time of Event:*
Start to Finish (ex: 6pm - 8pm)
Type of Event:*
Other Event Types (Please specify here):
Type of Appearance Requested:*

What Is Your Company/Chapter Willing to Cover? (check all that apply):*

Rows	Yes	No
Honorarium (If Yes, Fill in Amount)
Roundtrip Transportation (Airfare, Train Fare, etc., please list all that apply)
Hotel Accommodations

All Honorariums will be donated to the Foundation of the National Student Nurses' Association, Inc. (FNSNA).
Company:*
Contact Name:*

First NameLast Name
Contact Number:*
Please enter a valid phone number.
Contact Email:*
example@example.com
Upload Event Flyer for NSNA Announcements:

Cancelof
Requests must be received one month before scheduled event.
Should be Empty: