The deadline to accept a 2008 NOA nomination is 5 p.m. on Monday, March 31.

In order to ensure you do not lose your work, we strongly suggest that you complete these questions on a separate electronic document and then cut and paste your responses into the form fields. This will ensure your work is safe if the form should malfunction in any way while you are submitting your response.

Eligibility: Nominees must be a RN or LPN, must hold an unrestricted license, and must practice or have practiced nursing in Northern Nevada. Candidacy for the category of Lifetime Achievement is reserved for individuals who have been a nurse for 25 years or more and who have made contributions to nursing in Northern Nevada.

If you have any questions regarding the nomination process, please contact Laurel Lindstrom at (775) 328-1209.

Items marked with an * are required!
Please provide your contact information:

First Name:*
Last Name:*
Mailing Address:*
City:*
State:*
ZIP:*
Employer Name:*
Work Phone:*
Work Fax:
E-mail:*
RN/LPN License Number:*

Please select the category for which you have been nominated:

Nomination Category*



If you feel your contributions to nursing are better represented by a different category, please select a new category under which Nurses of Achievement should list your nomination:



Please answer the following questions as thoroughly as possible.

1) How long have you been a licensed, registered nurse?*
2) What is your current position/title/certification and/or credentials?*
3) Please write a brief personal biography. Information may include membership and/or offices held in professional and non-professional organizations, volunteer service activities, other awards/recognition you have received, and any publications in which you have been published. No CV's please.*
4) Describe specific examples that demonstrate your achievement in the category for which you have been nominated. If you have been nominated for Lifetime Achievement, please describe specific examples that demonstrate your achievements and contributions in Northern Nevada.*
5) Describe specific examples of how you act as a role model for nursing.*
6) As a nurse, what are you most proud of?*
7) What advice would you give to someone considering becoming a nurse?*
  (The form will take a few seconds to process. Please be patient.)