Nominate A Nurse

Nominations Deadline: MARCH 5, 2010

Criteria for Nomination

RNs and LPNs (full or part-time) who demonstrate excellence may be nominated for recognition by their employers if they are involved in clinical practice, leadership, scholarship, and/or education.

Made a significant impact on patient care and/or the nursing profession
Gone "beyond the call" in a clearly illustrated scenario
Demonstrated excellence above what is normally expected
Shown commitment to the community served in a way that is significantly above the norm
Achieved a life-long legacy in a particular arena

Nightingale nominations are accepted from health care organizations.

Please complete the fields below and submit with the fee of $100 per nomination.

A digital photo of the nominee should also be uploaded.

Primary Contact Information ***PLEASE NOTE - This page will time out after 15 minutes of inactivity, it would be best to prepare your narrative before filling out the form to avoid any loss of input.
Nominating Organization
Contact Person
Street Address
City State, Zip	,
Phone Number
Fax Number
Email Address
Nominee Information
Nominee Name
Credentials
Phonetic Spelling
Home Address
City State, Zip	,
Phone Number
Email Address
Nominee Photo	Send Photo Later
Every nurse is caring and committed to his or her patients, students, co-workers, etc. In 300 words or less, please tell us what sets this nurse apart from other caring nurses. To be considered for the award, specific examples and information clearly relating to the Criteria for Nomination list must be cited.
Nomination Narrative You may cut and paste from Word (limit 300 words please) ***PLEASE NOTE - This page will time out after 15 minutes of inactivity, it would be best to prepare your narrative before filling out the form to avoid any loss of input.
Details
Chose Your Method of Payment	Secure Online Payment Mail in a Check

Nominate A Nurse

Criteria for Nomination

Primary Contact Information

Nominee Information

Details

Nominate a Nurse

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