Please use this information and answer accordingly in the answer area below:
Individual Submitting this Form:
- Name (First & Last)
- Student:
- NSNA Membership ID #
- Expiration Date
- Program (ADN, LPN, RN to BSN, BSN, etc.)
- Faculty:
- Please identify if you are a professor or faculty advisor
- Your credentials (RN, BSN, etc.)
- Chapter (in which you are apart of)
- College (in which the chapter resides at)
- Address of the College
- Phone Number
Individual who is to be recognized:
- Name (First & Last Full Name)
- NSNA Membership ID #
- Expiration Date
- Chapter (in which they are apart of)
- Program (ADN, LPN, RN to BSN, BSN, etc.)
- College (in which the chapter resides at)
- Address of the College
- Phone Number
- Academic GPA (needs to be 3.0 or above)
Essay Prompt (please include these points in your paragraph, if the individual wins, this will be read at the conference):
- Local Chapter, NSSNA, NSNA involvement
- School involvement/accomplishments
- What makes them stand apart/out from other nursing students?
- Tell us about a time that they went above and beyond for their patient(s)
- Why do you think this individual is deserving of this award?