Margaret Allwright Award for Achievement in Nursing Practice

Margaret Allwright Award for Achievement in Nursing Practice
Name*

First NameLast Name
Submission on behalf of yourself or your team/ward/organisation*
Phone*
Enrolled Nurse / Registered Nurse / Registered Midwife*
Current Role*
Hospital / Facility / Service*
Email*
Please note that ALL formal communication will occur by email so please ensure this information is correct.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
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Scholarship Eligibility

Please answer the following questions about your eligibility for this scholarship.

Individual applications
Ahpra Registration with the NMBA (i.e. Enrolled Nurse, Registered Nurse or Registered Midwife, if you are an undergraduate student you are not eligible for this scholarship)*

YesNo
Applicants must be a resident in Tasmania for two years prior to the application (if your answer is no you are not eligible for this scholarship)*

YesNo
Team/Ward/Organisation applications
Application is for a Tasmanian Nursing/Midwifery Project*

YesNo

Referee Details

It is your responsibility to forward the Referee Report to each referee and to submit the reports as part of your online application.

Referee 1
Name*

First NameLast Name
Phone*
Email*
example@example.com
Position*
Attach the report for referee 1*

Cancelof
Referee 2
Name*

First NameLast Name
Phone*
Email*
example@example.com
Position*
Attach the report for referee 2*

Cancelof