Nurses of Distinction !

Nursing, Consultants, Educational and Health Services (NCEHS) invites nominations to the Millennium Edition of Nurses of Distinction. Nominees should have been in nursing one or more years, be active and civic minded in his/her community, be a good role model for nursing, and be a supporter of other nurses and the profession.

If you would like to see a recent press release and read Frequently Asked Questions about the Millennium Edition of Nurses of Distinction, click here. If you would like more information about Nurses of Distinction, email info@ncehs.com.

To nominate, please fill out the form in its entirety so that your nominee can receive the best possible opportunity. All nominations, including self-nominations will be accepted and reviewed for inclusion. Please include the name of the nominator. If your prefer to fax, please fill out the form entirely, print and fax to the attention of Angela Floyd at 210-698-8701.

Nomination Form For Nurses of Distinction

Nursing Category (Check One)

School     Geriatrics     Psychiatry     Orthopedics     Operating Room
Long Term Care   Medical    Cardiac    Administration
Entrepreneurship     Consultant    Educator
Other

Nominee First Name:

Nominee Last Name:

Address:

City:,

(E-Mail):

(H) Phone:

(F) Phone:

(W) Phone:

Title:

Current Position:

Highest Degree/Education:

Diploma AD BSN MSN Ph.D Ed.D DNS

Other:

RN LVN (Check One) Male Female
Length of Time In Profession

**Important Required Information**
**This portion of the form must be completed in
order for an evaluation and selection to be made. Forms submitted without this information will not be considered**

Why this nurse should be considered a Nurse of Distinction based upon nursing quality, presentation, publications, authorships, community activities, special honors and related.

Nominator:

Self Nomination: Yes

List two persons who can vouch for this person's nomination with an email address, fax, or telephone number.

1. Email / Phone / Fax#

2. Email / Phone / Fax#

Does the nominee accept this nomination? Yes No

Data submitted by: