Basic Profile Sheet

This form is COMPLETELY voluntary.  We are asking for Basic Profile info to better understand our members.  This information is only used by the PiFNP Leadership understand demographics and expertise.  We will list you on our website to help you be found by your expertise and discipline (see members page).  

Specifically, if you are a job seeker we would like to better understand your background to match you with upcoming tour and panel opportunities.  Note tours and panels are strictly for job seekers who have pledged.   

HINTS: Take advantage of the last two Optional Free Text Fields to let us know how to help you better.   DO NOT USE AUTO FILL.  Provide your FULL LinkedIn address.

We also encourage working members to join us to collaborate, attend trainings and volunteer to be mentors.  

First Name: (please do not use all cap)*
Last Name:*
Tag Line (Job Title):*
E-mail Address:*
LinkedIn Profile Address: (this is your online brochure, please provide full address https://www.)
Are you a job seeker?*
Nearest Major Location: (pick one, use Other to tell us your city)*
How would you like to be involved with PiFNP? (select highest interest, allow multiple picks)*
Discipline #1: Select one that best matches your area of study or experience.(1)*
Discipline #2: (optional) second best fit.
Function #1: Select one that best describes your past or future role.*
Function #2: (optional) second best fit
(Optional) Provide as many key words as desired to describe your expertise. We will search this field to match candidates for tours and panels.
What training topics most interest you? (use key words)
(Optional) Upload Signed Pledge: [required to attend tours and panels]