Deadline January 31st, 2023
This application is to be used to apply for all community service and health awards A SEPARATE APPLICATION FOR EACH PROJECT MUST BE SUBMITTED! Please indicate which award the application is for each time
Please indicate which award this application is for.
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Please Select
Most Outstanding Community Service
Most Unique Community Service
Email Address
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example@example.com
School Association
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Community Health Chairperson or leader of project.
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Project sponsor (name of NSNA school)
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Date(s) of Project
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Month
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Day
Year
Date Picker Icon
Additional Dates
Site(s) of project
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Number of nursing students involved
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Number of others collaborating (describe)
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i.e. Community members, other college students, etc.
Number of people attending (if applicable)
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List community organizations that may have assisted with project
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Cost of project
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Describe the goals for this project
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Describe what the project was
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What was learned from this project that would be beneficial to others?
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Did students receive class credit for participation in the project?
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Yes
No
If yes, please explain the type of credit received
Person to contact
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Please attach any publicity or other materials that can describe the project.
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