Do you know an outstanding Student Registered Nurse Anesthetist (SRNA)? Nominate him/her below for Somnia’s First Annual SRNA of the Year Award! This year’s award recipient will receive an Amazon Echo. 

Those who submit nominations will receive a $10 Amazon gift card as a Thank You! Deadline for submissions is midnight, Friday, February 9, 2018. The winner will be announced on Friday, February 16, 2018.

*1.Your Name(Required.)

*2.Your Email Address(Required.)

*3.Your Phone Number(Required.)

*4.Your Employer & Job Title(Required.)

*5.May we let the nominee know you nominated him/her?(Required.)

Yes 

No

*6.Nominee's Name(Required.)

*7.Name of school nominee attends(Required.)

*8.Name of facility at which nominee practices anesthesia(Required.)

*9.Nominee's Email Address(Required.)

*10.Nominee's Phone Number(Required.)

*11.Do you go to school with the nominee?(Required.)

Yes 

No

*12.Do you work with the nominee?(Required.)

Yes 

No

13.What qualities, characteristics, or actions make the nominee an outstanding SRNA? How does s/he exemplify high quality anesthesia care?

14.Please add any additional comments.