Welcome       Winners   
 
Registration
 
Register for our contest by filling out the form below. Registration is required for voting.
 
General Information
 
* Your First Name: 
 
* Your Last Name: 
 
* User Name: 
 
  Must be 4-10 characters
 
* Your Email: 
 
  Only one registration is allowed per email address.  This is how we will contact you so please use an account that you monitor daily.
 
* County Nurse Works In: 
 
  Nurse must work in one of the counties in the WSAZ DMA.  See rules for list of counties.  Enter the name of the county in this field.  Non-DMA counties will be eliminated from the contest.
 
* Zip Code: 
 
  Your Zip Code, not the nurses zip code.
 
Double check to make sure your information is correct and then hit submit below. Thank you for your participation.
By submitting the form you are confirming you are at least 18 years of age and have read and agree to our terms of service and privacy policy.
 
 
   Official Rules      Help      Feedback   

A Salute To Nurses

    Powered by © UPICKEM    All rights reserved.