American Nurses Association Massachusetts
Friendof Nursing Award
The American Nurses Association MassachusettsFriend of Nursing Award is for a person or persons who have demonstrated strong support for the profession of nursing in Massachusetts. The candidate for this award may be self- nominated or be nominated by a colleague. Award recipients are asked to serve on the following year’s selection committee.
The Friendof Nursing Award is presented each year at the ANA Massachusetts Awards Dinner Ceremony held in early spring. Award recipients are asked to serve on the selection committee for the following year’s awards.
Eligibility / Selection Criteria
Eligibility
Has worked to promote the profession of nursing in Massachusetts
Has worked to promote a positive image of the profession of nursing in Massachusetts
Has worked to promote the growth of the profession of nursing in Massachusetts
Required Elements
Must be completed electronically, or word-processed, submitted simultaneously, and in triplicate
Completed Application
Resume or curriculum vitae-containing previous academic and continuing education, professional and organizational activities, certification, publications or presentations (optional if peer nominated; may be requested if candidate is selected).
Two letters of reference (original only; do not need to submit copies)
One must be from an ANA Massachusetts member
The second should be from someone who can evaluate the candidate’s support for the
profession of nursing.
The recipient of this award must agree to serve on the selection committee for the following year’s award.
Instructions for completion
Real signatures are required where indicated in blue on the application (not computer generated).
Letter of recommendations: Have each person writing a recommendation send it to you in a sealed envelope with their signature across the seal and submit the sealed envelopes to ANA Massachusetts along with your application. Provide each person with a copy of the recommendation form and a stamped envelope addressed to you.
Friends of Nursing Award
Application
Nominator Information (if peer nominated)
Name:
Address:
City/State/Zip:
Home phone (include area code):Home Fax:
E-mail address:
Check box if ANA Massachusetts Member:
Candidate Information
Name:
Address:
City/State/Zip:
Home phone (include area code):Home Fax:
E-mail address:
Current Employer:
Position/title:
Work Phone:Work Fax:
Dates of Employment:
Education:
Names of higher education institutions attended and degrees obtained (start with highest degree)
Educational Institution Degree Year
______
______
______
______
Check box if ANA Massachusetts Member:
Friend of Nursing Award
Essay: (Maximum two typed pages) May be attached as a separate document.
If self- nominated: Describe an example of how your work has promoted and strengthened the profession of nursing in Massachusetts.
If peer-nominated: Describe an example of how the candidate has promoted and strengthened the profession of nursing in Massachusetts
I certify that the information contained in this application is true and correct to the best of my abilities
Signature: ______
Friend of Nursing Award
Letter of Recommendation
______has applied for the Friend of Nursing Award and has given your name as a reference.
Please provide your assessment of the applicant’s contributions to strengthening and promoting the profession of nursing in Massachusetts. Please also indicate in what capacity you know the applicant. One additional page may be attached.
Signature______Phone number ______
Print name: ______Title: ______
Position: _____ Date: ______
Are you a member of ANA MA Yes No
Please seal, sign across the seal, and return this recommendation to the applicant in the stamped envelope provided by the applicant. The applicant must return all documents to gather to ANA MA postmarked no later than January 5, 2016. Thank you in advance for completing this reference in a timely manner and for sharing your perspectives on the applicant!
Friend of Nursing Award
Applicant Check List:
Incomplete or partial applications will not be considered.
- Application
- Resume or Curriculum Vitae
- Essay
- Two letters of recommendation in sealed envelopes
Recommendation from ANA MA member
- Recommendation
- All signatures noted in blue contain real (not computer generated) signature.
Must be postmarked/submitted electronically by January 5, 2016.
Completed applications should be mailed to:
Chair, ANA Massachusetts Awards Committee
C/O ANA Massachusetts
P.O. Box 285
Milton, MA02186
Emailed applications should be sent to:
American Nurses Association Massachusetts
PO Box 285 ~ Milton, MA 02186 ~ 617-990-2856
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