NEAA Achievement Awards and R. Louise McManus Medal Application

NEAA Achievement Awards and R. Louise McManus Medal Application

March 9, 2025
Please review the information on https://tcneaa.org/neaaawards/ and have everything ready before starting this form. You will not be able to return to the form to complete it.

Contact Awards Committee:

Barbara Krainovich-Miller bk30@nyu.edu

or text Dr. Krainovich-Miller at 917-488-8639 (preferred) or call her on the same number.
Name of Nominator*

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
The person you are nominating must be an Active/Retired (dues current) or Life member of the Nursing Education Alumni Association.
Is the person you are nominating an NEAA member?*
Note that NEAA will verify membership status and if not a member, nominee will be invited to join NEAA.
Name of person you are nominating*

First NameLast Name
Email address of person you are nominating*
example@example.com
Cell Phone Number of person you are nominating*
Please enter a valid phone number.
Additional Phone Number
Please enter a valid phone number.
Submitting for which award?*
TC Degrees Earned*
Upload Curriculum Vitae of Nominee (PDF)*

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Nominator Support Letter (PDF)*

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Support letter #1 (PDF)*

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Support letter #2 (PDF)*

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Additional letter (not required) (PDF)

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Additional letter (not required) (PDF)

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Address of person you are nominating*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Thank you for your nomination.
Should be Empty: