Fillable 2020 DISTINGUISHED ALUMNI AWARD NOMINATION FORM (Baylor University)

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2020 DISTINGUISHED ALUMNI AWARD NOMINATION FORM (Baylor University)

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2020 DISTINGUISHED ALUMNI AWARD NOMINATION FORM
The Baylor University Louise Herrington School of Nursing seeks your nominations for the 2020 Distinguished Alumni Award.
Nominees should exemplify scholarship, leadership and service as described in the following categories:
LEARN - Significantly or uniquely contributes to the nursing profession through clinical practice, education and teaching,
administrative leadership, research, writing, publishing, and/or healthcare innovation.
LEAD - Demonstrates leadership in community affairs, nursing professional organizations, and in growth and development of
others in these areas.
SERVE - Positively promotes and advances the nursing profession in the community through volunteering and/or outreach efforts.
The Distinguished Alumni Award will be presented at the Alumni Reunion on April 25, 2020. The deadline for receipt of your nomination is
February 15, 2020. Please mail completed nomination forms to the address noted below.
NOMINEE INFORMATION
Full Name ______________________________________________________________________ Class ______________
Mailing Address _____________________________________________________________________________________
Phone Number ______________________________________________________________________________________
Email Address ______________________________________________________________________________________
NOMINATOR INFORMATION
Nominated by _______________________________________________________________________________________
Mailing Address _____________________________________________________________________________________
Email Address ______________________________________________________________________________________
Phone Number ______________________________________________________________________________________
REASON FOR NOMINATION
Please provide as much specific information as possible to indicate the ways in which your nominee meets these criteria. You may wish to
solicit help from your friends or colleagues. The committee will also seek additional information on nominees when necessary.
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Return this form to: Tina Glaspie, 333 N. Washington, Dallas, Texas 75246 .
Nominations are due by February 15, 2020. Recipients will be notified by March 1, 2020.
For more information, contact Tina Glaspie at (972) 576-9219 Tina_Glaspie@baylor.edu
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2020 DISTINGUISHED ALUMNI AWARD NOMINATION FORM (Baylor University)

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Completed 22 July 2020

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