Join The PNA

First Name(*)

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Surname(*)

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Gender

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Address(*)

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Email Address(*)

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Mobile Number(*)

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Date of Birth(*)

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Student Membership (MUST SELECT)(*)

YESNO

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Previous or Current Union (If you are currently or have in the past twelve (12) months been a Member of another Union, please state which Union)

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Do you wish to stop your current union fees and join the PNA?

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Grade(*)

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Qualifications

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Current Practice Address(*)

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Local Branch

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Are you a member of another Union’s Salary Protection Scheme?

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Payroll Officer (HSE Location)(*)

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Deduction Preference (SALARY DEDUCTION MUST EQUATE WITH YOUR SALARY PAYMENT PERIOD)(*)

Fortnightly €11Calendar Month €23.86Yearly €15 Associate Membership (Retired Nurses Only)

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NMBI Pin Number(*)

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Payroll Reference Number(*)

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HSE Authorisation(*)

YESNO

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By ticking the "Yes" box you are authorising PNA Head Office to forward your details to the relevant HSE Salary Department on your behalf. If no, please let us know why in Other Info below.

Tick YES for PNA Plus discounts worth €710
Please note: Discounts are provided by Cornmarket who will contact you about PNA Plus. (*)

YESNO

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Other Information

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Your Consent

The PNA Data Privacy Notice is available online here and by request from any member of staff or throughout the volunteer network. It is essential that you familiarise yourself with this policy as it details all aspects of how your data will be used by the PNA

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Yes - By ticking this box I am consenting to PNA forwarding my personal data, as per this form, to the relevant HSE Area, Employing Authority for processing union subscription, PNA Branch/Officer Board for general clearance purposes and any representation purposes which may arise and Cornmarket in the case of PNA Plus.No - By ticking this box I DO NOT consent to PNA forwarding my personal data, as per this form, to the relevant HSE Area, Employing Authority for processing union subscription, PNA Branch/Officer Board for general clearance purposes and any representation purposes which may arise and Cornmarket in the case of PNA Plus.

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Please select your consent or decline consent for each element. If no consent is given, we cannot complete your online application, please contact us at Head Office.

Security (This is NOT case sensitive)(*)

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Event Date	15-05-2024 1:00 am
Event End Date	16-05-2024 11:30 pm
Cut off date	01-02-2024 11:30 am
Individual Price	PRICE ON APPLICATION

PNA Registration Form

Upcoming events

HORATIO CONGRESS MALMO, SWEDEN 15th-16th MAY 2024