Alabama WMU
Saturday, September 23, 2017
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Faith Community Nurse Class Registration

Thank you for registering for the Faith Community Nurse Class (formerly Parish Nurse).

You can expect this class to be a life-changing event, as well as spiritually renewing!

 
Class Fee: $495, which includes the course fee, meals, lodging (semi-private), course materials, continuing education credits, course certificate, and Faith Community Nurse pin. The class fee also includes your first year's membership in Alabama Baptist Nursing Fellowship. For a private room, add $60 per weekend. For extra nights lodging, add $45 per weekend.
 
Continuing Education Units: 34 ABN contact hours of nursing continuing education will be awarded at the compleion of the course by NurCE, an ABN approved provider of continuing education for RNs and LPNs (provider #ABNP0004).

The class size is limited to 20 participants, so early registration is encouraged.  

Please u
se the registration form below if you are paying by credit card online (Visa, MC, Discover).
 
*indicates required field. 
       
Name
Address*
City* 
State*
Zip*   
Home Phone*  
Cell Phone
Work Phone   
Email* 
Workplace
Emergency Contact:
Name*
Day Phone*  
Evening Phone*
Congregation Affiliation: 
Church Name*
Address
City*
State*
Zip*
Church Phone
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
I am registering for:
Class with semi-private accommodations  ($495) 
Class + Private Accommodation ($555) 
Class + Extra Nights Lodging ($585) 
Class + Private Accommodation + extra nights lodging ($645) 
 
Do you hold a current, active Registered Nurse license in the state in which you practice?*  
Yes     
    No      
 
Are you currently working as a Registered Nurse? 
Yes         No       

If not, when was your last nursing position held and where?*
                                                       

My highest level of education in nursing is?      

Are you currently working as a faith community nurse (or parish nurse)?
Yes    No       
 
If yes, how long have you been a faith community (parish) nurse? 

If yes, is your position paid?
Yes    No               

If paid, are you institutionally paid  or congregationally paid            
 
Your application is not complete until we receive a personal letter addressing why being a Faith Community Nurse (formerly Parish Nurse) is important to you at this time in your life. In addition, please include a letter of endorsement by your pastor, institution, or congregational sponsor. You will receive a confirmation letter when your application is complete. Your letter can be emailed to khelms@alsbom.org or mailed to Faith Community Nurse Class, Alabama WMU, PO Box 11870, Montgomery, AL, 36111-0870. You may fax them to 334-288-2693.