Complete Member Application

Fill out and submit the simple form below – and you can begin enjoying the many benefits of NursesUSA immediately.

Please complete form below. Fields in red must be completed in order to process.

First Name
Middle Name
Last Name
Home Address 1
Home Address 2
Daytime Phone
Please Re-Enter Email:
Are you a Nurse? Yes  No
If yes, number of years of Nursing:
Currently Nursing? Yes  No
If no, why currently not Nursing?   Retired
  Changed Career
  Can't Find Job
Licenses? Select all that apply   LPN
Where do you work? Select all that apply   Hospital
  Nursing Home
  Doctor's Office
  Corporate Office
  Surgical Center
  Private Home
Biggest Concern as a Nurse?
Yes, please subscribe me to NUSA's member newsletter,
NursesUSA Monitorsm, which I will typically receive via email twice a year.
Yes, please subscribe me to NUSA's email newsletter,
NursesUSA Heartbeatsm, which I will receive typically via email weekly.
Yes, please send me other periodic NUSA member communications.
Please don't send me any of the above.

*Membership in NursesUSA is normally $35, but for a limited time, it is free. You will be notified in advance of any changes in the membership fee policy and have the option to cancel your membership at any time.

Since your membership is an online membership, we communicate with you via email. The primary communications are through our member newsletters. Occasionally, we will send you a separate email communication, but please be assured that we are sensitive to your time and will not bombard you with email communications. Note that NursesUSA will not sell your email address and personal contact information to third parties.

If you do not wish to receive our email communications, you can easily opt out by simply clicking "Member Communications Opt-Out Request" on the following page after you press "Submit."

If you have any questions or comments, please contact us at or 614-497-4088. Thank you.

PO Box 1597
Ocean View, DE 19970
Tel: 614-497-4088

Office hours: M - F, 8:30am - 5:00pm EST
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