Nomination Form

To nominate a nursing professional to be honored in our Compassion Awards program, please complete this form.  At the program's conclusion, we will award each of three honored nurses $500 as a modest token of appreciation, and produce a short feature describing their compassionate service which will air on 94.9 the River, 107.1 K-HITS and J105.  Any nursing professional from any hospital, clinic, home service or other facility is eligible.  The Compassion Awards are underwritten by Saint Alphonsus Regional Medical Center, Butler Heating and Cooling, and by Ennis Fine Furniture. Thank you for your nomination, and good luck.  

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* 1. Please enter your name

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* 2. The name of the nurse you're nominating.

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* 3. And the facility or location at which they performed their services.

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* 4. Next, please provide your email address.

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* 5. And the best phone number at which to reach you.  (Only for purposes of information gathering should we select your entry.)

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* 6. Now, please tell us a little about why you've elected to nominate this particular nursing professional.  Please be as specific as you wish.

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