Life Member Price: $315 for 10 Years First Name:* First Name Required Last Name:* Last Name Required Email:* Email is Required Mobile Phone:* Mobile Phone is Required Credentials:* Credentials is Required Gender:* Gender is Required Male Female Other Prefer not to answer Street Address:* Street Address is Required City:* City is Required State:* State is Required Zip code:* Zip code is Required Work Status:* Work Status is Required Employed Retired Student Other Position Description:* Position Description is Required Nurse Clinician / Staff Nurse Nurse Informaticist Academic Educator Manager / Coornator Nurse Scientist Staff Educator Patient Educator Clinical Trial Nurse Quality Improvement Director VP / CNO / CEO Consultant Entrepreneur Nurse Navigator Nurse Practitioner Retired Student Other Speciality Certification:* Speciality Certification is Required Advance Practice Provider:* Advance Practice Provider is Required Nurse Practitioner Clinical Nurse Specialist Nurse Midwife Nurse Anesthetist Not applicable Highest Degree earned:* Highest Degree earned is Required How would you like to be involved in CINA?:* How would you like to be involved in CINA? is Required Professional networking Continuing education activities Mentoring Career advancement self-help group Committees/Leadership Community outreach activities Not at this time I do here by declare that I will abide by the rules and regulations set by the California Indian Nurses Association (CINA).* Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Password Strength Password must be "Medium" or stronger No val Please fix the errors above