NEAA Achievement Awards 2021

Nursing Education Alumni Association, Inc.
Alumni Achievement Awards and McManus Medal Nomination
Deadline Monday March 22, 2021
Name of Nominator *

First Name Last Name
Nominator Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Nominator email address *
example@example.com
Nominator phone number *

Area Code Phone Number
The person you are nominating must be an Active/Retired (dues current) or Life member of the Nursing Education Alumni Association. If you are unsure if the person is a current or Life member, please contact diane@nsna.org
I have verified that the nominee is a current NEAA member *

Yes Is not a current member but will pay dues before March 22, 2021
Name of person you are nominating *

First Name Last Name
Address of person you are nominating *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail address of the person you are nominating *
Phone Number

Area Code Phone Number
Submitting for which award?
Submitting for which award? *

R. Louise McManus Medal Nursing Scholarship and Research Award Nursing Education Award Nursing Practice Award Nursing Service Award Leadership in Professional and Allied Organizations Award
TC Degrees earned *

Baccalaureate Masters MEd Masters MA Doctor of Education EdD
Curriculum Vitae of Nominee *
Nominator Letter *
Support letter #1 *
Support letter #2 *
Additional letter (not required)
Additional letter (not required)
Should be Empty:

Nursing Education Alumni Association, Inc.