Distinguished Advocate for Nursing Award 2027

Distinguished Advocate for Nursing Award Form 2027

Deadline to Nominate: Friday, March 26, 2027

Nominations received after the deadline will not be considered. It is very important that you use your best evidence to discuss why you believe your nominee should receive this honor. The committee uses only the information written by you regarding the nominee. Please use additional paper and include the nominee’s curriculum vitae or professional resume if available.

Personal phone calls and/or letters of congratulations will be mailed or emailed to winners in early April. All award winners will be acknowledged at the end of our Nurses Expo Conference on Friday, April 23, 2027; award winners and nominees are encouraged to attend Nurses Expo.

If you have any questions, please feel free to contact statelinenurses2013@gmail.com.

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Nominee Information:

CRITERIA: This award is given to an individual, group, agency, or institution that has promoted and/or supported nurses, the nursing profession, or the specific missions of nursing. Previous winners are eligible for re-nomination provided they are being nominated for accomplishments made-after-their past award. (Please write the name of the contact person for the nominated group, agency or institution that is to be notified if a group is chosen for the award.)

Nominee Name*

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Home Address*

Street Address Address Line 2 City State ZIP Code

Mailing Address (if different from above)

Street Address Address Line 2 City State ZIP Code

Home/Cell Phone*

Business Phone*

Email*

Work Title/Credentials*

Employer*

If a group, please list individual names (if known)

How has the individual, group, agency or institution promoted nursing or nurses?*

Additional Comments

Nominator Information:

Nominator's Name*

First Last

Home Address*

Street Address Address Line 2 City State ZIP Code

Home/Cell Phone*

Business Phone*

Email*

Relationship to Nominee*