SC ENA Nominations of the Year Form

South Carolina Emergency Nurses Association Nomination Form
All entries must be received no later than August 31, 2025, for consideration by the selection panel. The form must be completed in its entirety.
Award Nomination*

ER Nurse of the YearER Nurse Leader of the YearER Provider of the YearER Support Staff of the YearER Nurse Educator of the YearER Emerging Professional of the YearEMS Personnel of the Year (Pre-Hospital Care)ER Advanced Practice Clinician of the Year
Nominated by*

First NameLast Name
Email of Nominator *
example@example.com
Phone Number of Nominator*
Please enter a valid phone number.
Nominee*

First NameLast Name
Credentials (select all that apply)*

DiplomaAssociatesBachelor'sMaster'sDoctorateCENCPENTCRNCTRNCFRNN/AOther
Employer*
Nominee's Email Address*
example@example.com
Nominee's Phone Number*
Please enter a valid phone number.
Why does this nominee deserve to be recognized as the South Carolina Emergency _________ of the Year award?*
Be specific
Attach any documents, if applicable

Cancelof
Is the Nominee a SC ENA Member?*

YesNoUnsure
Signature*

Clear
Should be Empty:

South Carolina Emergency Nurses Association Nomination Form