2018 NCSN Recognition Award Nomination Form

The NCSN Recognition Award is presented during the annual NASN conference to a Nationally Certified School Nurse (NCSN) who:

Is nominated by a peer by February 28th, 2018;
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;
Is an active NCSN in good standing; and
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) are not eligible for the Award.

1. Name of Nominee and Credentials:

First Name

Last Name

Credentials

Address

City

State

Zip

Email Address

Phone Number (home)

Phone Number (work)

Employer

City/State

Title/Position