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Arizona School Nurse Committee Sign Up Form

The Arizona Department of Education, School Safety and Social Wellness Program is committed in its support of school nurses and staff of health offices in schools throughout Arizona. We have heard through our school nurse survey and SN HUDDLE sessions that many of you are interested in helping improve school health and the role of school nurses. Please complete the questions below to let us know which committee(s) you are interested in joining.
1.What is your first name?(Required.)
2.What is your last name?(Required.)
3.I work in:(Required.)
4.What is your work title?(Required.)
5.What is your school name?(Required.)
6.What is your school district name?(Required.)
7.What is your phone number?(Required.)
8.What is your email address?(Required.)
9.What committee(s) would you like to join? Select all that apply.