Student Member Registration - The PNA - The Psychiatric Nurses Association of Ireland

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 Discipline(*)

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Student Placement Hospital / Area(*)

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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 - In order to process your membership it may be necessary to confer with local branch officials, this is in keeping with PNA Rule book, Rule 3.3, Section 3, please tick this box to confirm your consentNo - In order to process your membership it may be necessary to confer with local branch officials, this is in keeping with PNA Rule book, Rule 3.3, Section 3, please tick this box to confirm that you DO NOT give your consent. Invalid Input

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

Yes - By ticking this box I am consenting to receiving PNA emails including news, offers and information relating to my PNA MembershipNo - By ticking this box I DO NOT consent to receiving PNA emails including news, offers and information relating to my PNA Membership Invalid Input

Please select your consent or decline consent for each element.

Security (This is NOT case sensitive)(*)

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PNA Student Registration Form