ARN is accreditedas a provider of nursingcontinuing educationthrough the AmericanNurses CredentialingCenter's Commission

on Accreditation.

Association of Rehabilitation NursesContinuing Education FeatureApplication Form

Instructions1. Photocopy this page for each article for which you are seeking credit and submit the copy to ARN.

DO NOT REMOVE THIS PAGE FROM THE JOURNAL.2. Provide the application information requested below.3. Complete the appraisal questions and the posttest question for the article for which you are requesting credit on

this application form.4. Submit all required materials to ARN with the processing fee. (Submit one application form for each article for which you

are seeking credit. Submit one check or money order that covers the processing fee(s) for all the credits you are applying for.)5. Mail with payment to ARN Director of Education, 4700 W. Lake Avenue, Glenview, IL 60025-1485. Please allow 30 days for ARN's

processing of the application and your receipt of the certificate of completion.

Application (Print or type; this information will be used to process your certificate ofcompletion.)

Name ARN member code _

Mailing address _

City, state, zip Daytime phone (~__-L. _

State oflicensure License number _

Positionltitle _

Date application submitted Signature

Independent study offeringsAll continuing education offerings in Rehabilitation Nursing will provide 1 contact hour to those who read the article and com­plete the application form appropriately. Please check the article for which you are completing this form.

D RNC-120 The Role of Exercise in Rehabilitation for Patients with End-Stage Renal DiseaseD RNC-121 Activity-Based Resource Allocation: A System for Predicting Nursing CostsD RNC-122 Health Promotion Among Ethnic Minorities: The Importance of Cultural Phenomena

To a great To a goodextent extent

Evaluation questionsPlease rate the following:

1. My knowledge of this subject before reading this article2. My knowledge of this subject after reading this article

3. The extent to which I achieved Objective #1 for this article4. The extent to which I achieved Objective #2 for this article5. The extent to which I achieved Objective #3 for this article (ifapplicable)6. The extent to which I will be able to apply this knowledge to my practice

Excellent55

5555

Good44

4

44

4

Fair Poor None3 2 13 2 1

To a fair To a poor Notextent extent at all

3 2 13 2 13 2 13 2 1

7. On another piece of paper, describe how you can apply what you learned by reading this article to nursing practice.Do not exceed one page; type or print your response clearly

First articleEach subsequent article

Fees (Fees are payable to ARN by check or money order only-no credit card charges will be accepted.)ARN members Nonmembers

$15.00 $25.00$7.50 $14.50 Total enclosed $ _

Expiration dateContinuing education credit will be given for each of these offerings through December 31, 1998. Applications received after thatdate will not be processed.

336 Rehabilitation Nursing s Volume 22, Number 6· NovlDec 1997