ANA-NY Awards 2023 Submission
Select Award
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Nursing Education
Nursing Practice
Scholarship
Nurse Heroes
Nominee Name
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First Name
Last Name
Nominee Email
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example@example.com
Nominee Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominee Phone Number
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-
Area Code
Phone Number
Nominator Name
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First Name
Last Name
Nominator Email
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example@example.com
Nominator Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Upload 2 letters of support here
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Nominator Phone Number
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Area Code
Phone Number
Explain how the nominee meets the award criteria? (Do not exceed 500 words)
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