Create New User Account

Create New User

Provide your information below to create a contact record with AAPACN. Please provide your work address.

Fields marked with an asterisk (*) are required.

First Name *

Last Name *

E-mail (Cannot be generic or shared company email address) *

Confirm E-mail *

Create Password *

Confirm Password *

- Credentials
- Functional Role *
- Organization Category *
- Cell Phone
  
  Secondary Email
- Address Type
- Facility Name *
  
  Corporation Name (can be the same as the facility name) *
- Street Address *
- City *
  
  State *
  
  ZIP *
- Country
- Mail to Work Address (If "no," add separate mailing address below) YesNo
- Mailing Address (if different from above)
- Street Address
- City
  
  State
  
  ZIP
- Country
- Are you an RN or LPN? *
  
  Years of nurse leadership experience
- How did you hear about AAPACN? *
- If you selected "other," please specify:
  
  If you said a friend or colleague referred you, please tell us who:

Cancel

Want to become a member? Join Now.

Once you’re logged into your new account, you can become an individual member by selecting Join from the My Account area.

New Organizational Members must contact their internal account manager after creating their account to activate membership benefits. They'll receive an email when their benefits have been turned on.

Create New User

Verification Code