BCNPA British Columbia Nurse Practitioner Association

Creating positive change in the health of all British Columbians

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Membership Application From

If you would like to learn more about what it means to be a member of BCNPA before registering or to register by mail please visit our membership page. If you are ready to register please complete the form below.

Personal Information

First Name*

Last Name*

Address*

City*

Province*

Postal Code*

Phone -- Ext.

Email*

(*) Required Fields

Employer Information

Education

Diploma Baccalaureate Masters Specialty Doctorate

Other

NP Educational Institutions

Graduation

Membership Type

Voting – Active (Must hold a full, provisional, on non-practicing license as an NP)
$200/year

Non-Voting – Associate (Applies to registered nurses and general public interested in the NP practice)
$50/year

Non-Voting – NP Student (Proof of student status or student ID required)
$50/year

Comments

Comments/Questions

Your privacy is important to us. We do not and will not share or sell your personal information with third parties without your prior written permission and consent. Please be aware, we do share your e-mail address with BCNPA approved agencies (e.g. UBC Therapeutics Initiative, Do Bugs Need Drugs, etc.), and publish your employer work and contact information on the NP directory on our website to help the public find service in their area, and to assist NPs in finding one another.

Please check one:

Yes. I understand the above and allow BCNPA to share my e-mail address with BCNPA approved agencies and organizations, and publish my employer work and contact information to the BCNPA directory.

No thanks. Please do not share my e-mail address to other agencies or publish my employer work and contact information to the BCNPA directory.

Due to a recent surge in fraudulent registrations, please enter the following words below

Please submit your form electronically and send a cheque for the appropriate amount in full to:
BCNPA
C/O 5368 Ivar Place
Burnaby, BC, Canada
V5G 2C5