Thank you for your interest in becoming a member of the Great Lakes Chapter of the Infusion Nurses Society (INS). Annual dues are $25.00 for one calendar year (January 2012 to December 2013).

If you are mailing your application with a check, please make your checks payable to: Great Lakes Chapter, INS

And mail the completed application and check to:

                        Jill Berk
                        30074 W. 12 Mile Rd, Unit 110
                        Farmington Hills, MI 48334

Note: Membership in the national Infusion Nurses Society is not required for local chapter membership.

Download application here.   

Or fill out our online application and pay by PayPal below.

Email any questions to info@greatlakesins.org



Great Lakes Chapter - INS
Keeping Infusion Nurses Informed
Become a Member Now
Great Lakes Chapter, Infusion Nurses Society 2012 Membership Online Application Form
Name
Home Address
Home City, State, Zip code
Home/Cell Phone Number
Work Address
Employer
Work City, State, Zip Code
Work Phone Number
Work Email Address
Home Email Address
Are you a new Great Lakes Chapter Member?
Are you a National Infusion Nurses Society Member?
If you were recruited by a current GLC member, who?
Is it OK to list your contact info in a Membership List?
Acceptance Mark
2012 Great Lakes Chapter Membership Dues. $25.00