Awards Nomination Form, Western Institute of Nursing

FOR: Presenters | Students | Candidates

Western Institute of Nursing
2009 Awards Nomination Form

Scroll down to the Nomination Form found below to nominate for the following awards:

To nominate someone for more than one award, you must submit a separate form for each award - do NOT use a single submission for multiple awards.

The deadline for submitting all nominations is 5:00 pm, Monday, November 3, 2008 (Pacific time).

Please check the award this nomination is for [please check only one]:



: This nomination is for an or a

NOMINEE

Telephone:

PERSON WHO IS SPONSORING THE NOMINEE:

Telephone:

SUPPORTING NOMINATOR #1 (required for all awards):

Telephone:

SUPPORTING NOMINATOR #2 (required for the Anna M Shannon Mentorship Award; the Jo Eleanor Elliott Leadership Award; and the WIN Emeriti Award):

Telephone:

Please submit the required supporting documents electronically to win@ohsu.edu.