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   Nursing Alumni Assoc. Home > Nursing Alumni Association > "Alumnus of the Year" Nomination Form

 

2010 "Alumnus of the Year" Nomination Form

Nominee’s Name:  

First
  

Middle/ Maiden
  

Last
Degree(s)/Year:   ASN   BSN   MSN   DSN
Other Degree(s)/Year(s):  
Address:   City/State:   Zip:
Phone #'s   Home:   Work:   Cell:

Instructions:

  1. Check appropriate performance category or categories.
  2. Submit a description of your nominee’s outstanding qualities based upon the selected category(ies).
  3. Please limit your submission to one typed page. Single or double spacing is allowed.
  4. Deadline for submission May 28, 2010.
The Alumnus of the year is someone who has contributed to nursing in one or more of the following categories:
 
  Profession Practice-Excellence in patient care, patient advocacy, policy change, certification, awards in clinical practice.
 
  Role Model-Professional associations, mentoring of others, consultant, nursing alumni association service.
 
  Leadership-Publications, in-services, presentations, spokesperson for nursing at local, state, or national level, professional committees.
 
  Community Service-Community clinical projects, represents nursing on community boards, political action to support quality health care.

Description of nominee’s outstanding qualities based on the selected category(ies):

NOTE: Current Alumni Association Board Members are ineligible for this award and Current Alumni Association Board Members are ineligible to submit an Alumnus of year Nominee.

Submitted by:
Name:
Degree(s)/Year:   ASN   BSN   MSN   DSN
Address:   City/State:   Zip:
Phone #'s   Home:   Work:   Cell:

Winner will be announced at our June, 2010 LSUHSC Annual Meeting. For additional information please contact Arlene Rome at 985.727.1983 or by e-mail: arome1124@charter.net


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