ORNAC Logo
Language/langue:

ORNAC Registration
Step 1 of 4: Enter registration information

Steps: Enter registration information > Verify your information > Select payment method > Enter payment information

Please complete the form below to register with ORNAC for the membership year. Fields with a red asterisk ( * ) are required.

There are several methods of payment. You can use a credit or Interac card.

If you have previously registered with us online and wish to renew your registration, please click here instead.

Registration Information
Registration Type: *

Are you unsure which registration type to choose? Click the blue question mark for more information.
Region:
I would also like to join the following group(s):
Registered Nurse First Assistant Network of Canada (RNFANC) ($10 fee applied at checkout)
Perioperative Nurse Educators of Canada (PNEC) ($10 fee applied at checkout)
Canadian Operating Room Leaders (CORL) ($10 fee applied at checkout)
Personal Information
First Name: *
Last Name: *
Country: *
Address: *

City: *
Province/State: *
Postal/Zip Code: *
Primary Phone: *

Format: ###-###-####
Secondary 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.
Employment Information
Employer/Hospital: *
Country: *
Work Address: *

City: *
Province/State: *
Postal/Zip Code: *
Work Phone:
ext
Format: ###-###-#### ext ####
Fax:
Work E-mail:
Employment Status: *
Current Position: *

If Other, please specify:
Nursing Information
Area(s) of Specialty *
(Check all that apply)
Cath Lab
CVS
Diagnostic Imaging
Endoscopy
ENT
General Surgery
Gyne
Labor And Delivery
Neurosurgery
Oral Surgery
Ophthalmology
Orthopedics
Pediatrics
Plastics
Thoracic
Vascular
Urology
Other:
Are you a member of CNA? *
Yes
No
CNA Certified? *
Yes
No
CPN(C) (within the last 5 years)? *
Yes
No
CPN(C) (within the last 5 years) Certification Number:
Year Certified/Recertified:
RN Registration Number: *
Are you an RPN/LPN? *
Yes
No
RPN/LPN Registration Number:
Education Information
Check all that apply:
Diploma
Post-Graduate OR Course
Baccalaureate
Masters
PhD
Are you currently enrolled in an educational program? *
Yes
No
Are you involved in perioperative research? If so, please specify what area:
If you are affiliated with a University, please specify which one:
Preferences and Privacy Options
Please send mail to: *
Work Address    Home Address
I am not interested in receiving emails regarding ORNAC news and upcoming events.
IMPORTANT: by selecting this option you are indicating that you DO NOT want to receive ANY email correspondence from ORNAC. ORNAC does not share member information and only sends email updates to members.
Create a Password for Future Visits
For future visits to the registration area of this site, you will be assigned a username and require a password for access. Please create a password for yourself by entering it below. Your password must be at least 6 characters and contain both letters and numbers.
Password: *
Re-type: *