INF Honor a Nurse

"Honor a Nurse" Nomination & Donation Form

We all know a special nurse who has made a difference to us or a patient/family. Honor a nurse who has touched your life as a friend, a caregiver, a mentor, an exemplary clinician or an outstanding teacher. Your honoree will receive a special acknowledgement letter in the mail in addition to a public acknowledgement through our quarterly publication, The Bulletin, which is distributed to more than 65,000 registered nurses and nursing students throughout Indiana. The acknowledgement will state the name of the donor and the honoree’s accomplishment, but will not include the amount of the donation. A contribution of at least $20.00 will honor your special nurse through the support of future grants and scholarships of the Indiana Nurses Foundation.
Your Name*

First NameLast Name
Your Credentials*
Your Email*
example@example.com
Honoree's Name*

First NameLast Name
Honoree's Credentials*
Honoree's Email*
example@example.com
Honoree's Work or Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please tell us why the honoree is deserving of recognition and any other pertinent details. This information will be shared within their recognition. Details can be shared from you to honoree or as general recognition.*
INF Designation of Donation

INF Donation in the Honoree's Name*

USDMinimum $20 Donation Required. Larger Donations Accepted.

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

"Honor a Nurse" Nomination & Donation Form