Nevada Nurses Foundation

Purpose:

To recognize and honor an outstanding nurse leader who is a role model for his or her peers and who is an active advocate for Nevada nursing and healthcare based on lifetime achievement and service.

Criteria for Selection of Award Recipient:

Nominees will be evaluated for their lifetime achievements and services provided in the following areas:

• leadership
• community service
• scholarly contributions
• political voice
• advocacy for nursing & healthcare

Scoring will be based on how well the nomination essays and the nominees' responses illustrate exemplary contributions in these areas. Nominees must have been licensed in Nevada for at least 10 years.

Celebration:

The award will be presented during the 2023 Shining Stars of Nursing Awards Dinner on Saturday, October 14, 2023, in North Las Vegas, NV, at the Aliante Casino, Hotel, & Spa.

Important Dates:

Please complete the form below to nominate a candidate for the Distinguished Nurse Leader by midnight on August 15, 2023.

Questions:

Questions about the nomination or award criteria or process should be directed to Stars@NVNursesFoundation.org or by calling 775-560-1118.

Technical issues with the nomination form should be reported to webmaster@NVNursesFoundation.org .

Instructions:

Please fill out this form as completely and accurately as possible.

Nominations must be submitted by the deadline above. This deadline will be strictly enforced, and late submissions will not be accepted.

After submitting an online nomination, you will receive a receipt and tracking number to confirm your submission.

Items marked with a * are required, and the form cannot be submitted if these values are missing!

Nomination Form:

Nominator Information
We ask for your name and contact information in case we have questions about your nomination. This information will remain anonymous and is securely encrypted before being stored.
* your name:
* professional credentials (RN, LPN, etc.):
*current position/title:
* your phone (nnn-nnn-nnnn):	okay to text: yes   no
* your e-mail:
About the Nominee
* nominee's first name:
* nominee's last name:
* Nevada license:	To your knowledge, has the nominee been licensed for at least 10 years in Nevada?     yes   no
Sorry, this person is not qualified to be nominated for this award.
home street address:
city:
state:	ZIP:
* nominee phone:	secondary phone:
* nominee e-mail:
* employer/ organization/retired:
Nomination Justification
Why do you believe this individual deserves to be recognized as a distinguished nurse leader? Please include examples of this individual's leadership, community service, scholarly contributions, political activities, and advocacy for nursing & healthcare (maximum 500 words).
submit at least one required field is empty or has invalid contents