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Outstanding Nursing Alumni Recognition Form

The Louisiana State University Health Sciences Center - New Orleans (LSUHSC-NO) School of Nursing (SON) has a rich heritage in educating and fostering the development of nursing leaders. This heritage displays LSUHSC-NO SON’s commitment to prepare women and men for leadership roles in nursing. In an effort to recognize these outstanding nursing leaders, the LSUHSC-NO SON has established the “Outstanding Nursing Alumni Recognition Program” in conjunction with its’ 85th Anniversary Gala Celebration.

ELIGIBILITY

The nominee must be a LSU School of Nursing Alumni. They can reside anywhere. Those selected, will be recognized at the 85th Anniversary Gala Celebration on November 17, 2018.

Nominations must be submitted by Monday, September 3, 2018.


NOMINEE (Must be a LSU Nursing Alumni)

First:
Middle:
Last:
Preferred E-Mail Address:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Employer Information:
Employer Name:
Work Phone:
Address:
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NOMINATOR

Name:
Preferred E-Mail Address:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:


NOMINATION NARRATIVE

250 to 500 words per each question.

1) How has the LSUHSC-NO SON’s nursing alumnus demonstrated significant contribution and/or achievement in advancing the profession of nursing and improving health care of the individual, family and/or community? Please provide examples.

2) Describe how the LSUHSC-NO SON’s nursing alumnus has upheld the values of stewardship, organizational citizenship, nursing innovation, caring, professionalism, respect, integrity, diversity, and excellence in nursing?

Upload CV of nominee:

 (.docx, .doc, and .pdf only)