Name of Nominee and Credentials

The NCSN Recognition Award is presented during the annual NASN conference to a Nationally Certified School Nurse (NCSN) who:
  1. Is nominated by a peer by March 5, 2021;
  2. Demonstrates achievements at the national, state or local level that (1) enhance the competence of school nurses or (2) effectively promote national school nurse certification;
  3. Is an active NCSN in good standing; and
  4. Is employed in school health.
A letter of recommendation addressing the above criteria must be submitted with this nomination form. Past and current members of the National Board for Certification of School Nurses (NBCSN) Board of Directors are not eligible for the Award.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Professional Credentials

Question Title

* 4. Street Address

Question Title

* 5. Street Address

Question Title

* 6. City

Question Title

* 7. State

Question Title

* 8. Zip Code

Question Title

* 9. Email Address

Question Title

* 10. Phone Number

Question Title

* 11. Employer Name

Question Title

* 12. Employer City and State

T