Nurse Specialized in Wound, Ostomy & Continence Canada (NSWOCC) - Membership & Associate Registration - Nurses Specialized in Wound, Ostomy, & Continence Canada (NSWOCC)

Registration Information

Registration Type: *

Are you unsure which registration type to choose? Click the blue question mark for more information.

Nurse Specialized in Wound, Ostomy & Continence Member ($100.00/Year): Available to NSWOCs licensed to practice within Canada. Members have voting privileges.

Retired NSWOC Member ($100.00/Year): Canadian registered NSWOCs who are no longer practicing and /or who no longer hold a valid license as a registered nurse within a Canadian province or territory. Members have full voting privileges.

WOC Student Associate ($100.00/Year): Available to those intending to attend the Wound, Ostomy and Continence Institute. This is an Associate registration type. Associates are not voting members.

Skin Health Practice Enrichment Series Associate ($0.00): Available ONLY to those intending to attend the Wound, Ostomy and Continence Institute Skin Health Foundations programs. Valid for one year only. This is an Associate registration type. Associates are not voting members.

Full-time Student Nurse Associate ($50.00/Year): Available to registered full-time students of an approved certificate, bachelors or diploma RN, LPN/RPN program (proof required). This is an Associate registration type. Associates are not voting members.

Healthcare Professional Associate ($90.00/Year): Health care professionals such as physicians, RPNs/LPNs, MDR certified technicians and non-NSWOCs who are stakeholders in wound, ostomy & continence patient care. This is an Associate registration type. Associates are not voting members.

Industry Associate ($175.00/Year): An Industry Associate is a company or institution involved with the development, manufacturing and/or selling of products relating to stomas. They may enroll one officer or employee as a representative. This is an Associate registration type. Associates are not voting members.

International Associate ($90.00/Year): NSWOCs and allied healthcare professionals (such as physicians, RPNs/LPNs, MDR certified technicians and non-enterostomal nurses who are stakeholders in enterostomal therapy patient care) who are not Canadian residents but are licensed in their country of residence. This is an Associate registration type. Associates are not voting members.

Personal Information

First Name: *

Middle Name:

Last Name: *

Maiden Name:

Gender: *

Country: *

Address: *

City: *

Province: *

Postal Code: *

Home Phone: *

Format: ###-###-####

Cell Phone:

E-mail: *

Re-type your E-mail below: *

**IMPORTANT: The above e-mail address is used as your primary contact method, so make sure you have typed it correctly before submitting. If you do not have a home e-mail, enter your work e-mail here.

Date of Birth: *

Employment Information

Employer/ Hospital: *

Country: *

Work Address: *

City: *

Province: *

Postal Code: *

Work Phone:

ext
Format: ###-###-#### ext ####

Fax:

Work E-mail:

Employment Status: *

Current Position: *

If Other, please specify:

Area(s) of Practice *
(Check all that apply)

Ostomy

Other:

Wound

Other:

Continence

Other:

Workplace *
(Check all that apply)

Other:

Responsible Areas *
(Check all that apply)

Other:

Area(s) of Interest *
(Check all that apply)

Other:

Professional Information

Professional Status
(Check all that apply)

Other:

RN or RPN/LPN Registration Number:

Member of the following Associations
(Check all that apply)

Other:

The addition of the JWOCN journal fees ($46) are automatically added unless the following is indicated:

WOCN Registration Number:

JWOCN Registration Number:

Education Information

NSWOC Course Name: Year:

WOCC(C)? *

No

Yes, Year Certified/ Recertified:

Nursing
(Check all that apply)

Non-Nursing
(Check all that apply)

Diploma

Baccalaureate

Masters

PhD

Preceptorship/ Mentorship

Area(s) of Interest
(Check all that apply)

Ostomy

Wound

Continence

Have Expertise in
(Check all that apply)

Ostomy

Wound

Continence

Preferences and Privacy Options

Preferred mailing address: *

Work Address

Home Address

Preferred contact phone and e-mail: *

Work Address

Home Address

I wish to receive the NSWOC Advance by: *

I wish to receive the JWOCN by (if applicable): *

I consent to having my contact information listed in the NSWOCC Membership Database, which is password protected for NSWOCC members.

I am interested in participating in the following
(Check all that apply)

Demographic Information

I plan to retire in:

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