THE TRAINED NURSES’ ASSOCIATION OF INDIA Headquarters: L-17, Florence Nightingale Lane, Green Park, New Delhi.

REGISTRATION FORM TOPIC: Roadmap from Research to Evidence Based Nursing Practice Seats: 50 Participants: Post graduate nurses, students and faculty Date: September 18, 2019 Venue: TNAI Headquarters, New Delhi

1. Name (in block letters):

2. Designation and Address of the institution you are working: Email ID_______________________________ Mobile No.___________________________

3. Age Experience in years

4. Professional Qualification:

5. TNAI Number _________________________ Date of enrollment: _________________ (Bring TNAI Membership card on the day of workshop) 6. Participation Fee: 500 for TNAI members 750 for Non-members

Date: ____________________________

Signature of the participant Credits Hours: 8