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.

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1. Your Name (Required.)

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2. Your Email Address (Required.)

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3. Your Phone Number (Required.)

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4. Your Employer & Job Title (Required.)

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

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6. Nominee's Name (Required.)

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7. Name of school nominee attends (Required.)

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

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9. Nominee's Email Address (Required.)

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10. Nominee's Phone Number (Required.)

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

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

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

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14. Please add any additional comments.

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