M. LOUISE FITZPATRICK COLLEGE OF NURSING MEDALLION

Nomination Form

AWARD DESCRIPTION

The Fitzpatrick College of Nursing Medallion is the highest award bestowed by the College to its alumni for distinguished achievement. It bears the seal of Villanova University which is an adaptation of the official seal of the Order of St. Augustine. The motto of the University as indicated on the seal is "Veritas, Unitas, Caritas" — Truth, Unity, Love — the special virtues to which Villanova subscribes and which it endeavors to inculcate in all of its students.

The Medallion has been traditionally awarded to degree candidates for outstanding academic achievement and to alumni in the following categories: Distinguished Contributions to the Profession, Leadership in Nursing Practice, Clinical Excellence in Nursing, Excellence in Nursing Education, Excellence in Nursing Research and Distinguished Service to the Fitzpatrick College of Nursing.

The Medallion is awarded to alumni at the College-sponsored and Nursing Alumni Association-sponsored Annual Mass and Alumni Awards Ceremony.

NOTE: You are required to upload the nominee's CV or resume as part of this submission. (PDF, DOC and DOCX files are accepted.)

Question Title

* MEDALLION:
(Nominations for 2020 are being accepted in the categories below.)

Please select one:

ABOUT THE INDIVIDUAL YOU ARE NOMINATING:
(Nominee must be a Villanova Nursing Graduate)

Question Title

* Is the Nominee a Villanova Graduate?

Yes

Please include Villanova degree(s) and year(s), if known.

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* Title of Nominee's Role or Position:

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* Nominee's Contact Information

Full Name and Credentials

Employer

Address

Address 2 (if none, insert N/A)

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* Nominee's Assistant's name and phone/email, if applicable.

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* NOMINATION
Why are you nominating this individual? Please describe briefly how, in your opinion, the Nominee meets the criteria for the Fitzpatrick College of Nursing Medallion.

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* What other comments would you like to add to assist the award committee in their decision making?

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* ABOUT YOU:

Name

Employer

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* Are you a Villanova graduate?

Yes

Please include Villanova degree(s) and year(s).

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* What is your relationship to the Nominee?

Work Colleague

Professional Colleague

Classmate

Friend

Relative

Other (please specify)

Question Title

* Please upload the nominee's CV or resume to accompany the nomination: (PDF, DOC and DOCX files are accepted - please include the nominee's name in the file name description.)

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* MEDALLION: (Nominations for 2020 are being accepted in the categories below.)Please select one:

Question Title

* Is the Nominee a Villanova Graduate?

Question Title

* Title of Nominee's Role or Position:

Question Title

* Nominee's Contact Information

Question Title

* Nominee's Assistant's name and phone/email, if applicable.

Question Title

* NOMINATIONWhy are you nominating this individual? Please describe briefly how, in your opinion, the Nominee meets the criteria for the Fitzpatrick College of Nursing Medallion.

Question Title

* What other comments would you like to add to assist the award committee in their decision making?

Question Title

* ABOUT YOU:

Question Title

* Are you a Villanova graduate?

Question Title

* What is your relationship to the Nominee?

Question Title

* Please upload the nominee's CV or resume to accompany the nomination: (PDF, DOC and DOCX files are accepted - please include the nominee's name in the file name description.)

* MEDALLION:
(Nominations for 2020 are being accepted in the categories below.)

Please select one:

* NOMINATION
Why are you nominating this individual? Please describe briefly how, in your opinion, the Nominee meets the criteria for the Fitzpatrick College of Nursing Medallion.