NOMINATION FORM – 2016

COMPLETED APPLICATIONS MUST BE RECEIVED BY NOONPT on March 18

Brenda Ashkar

“We Do What Ever It Takes” Award for

Outstanding Registered Nurse of the Year in Tuberculosis Control

The Brenda Ashkar Award is designed to:

  • honor the contributions of Registered Nurses who prevent and control TB in California,
  • honor the efforts of one outstanding Registered Nurse each year.
  • inspire Registered Nurses in their ongoing efforts to eradicate TB.

What is the Brenda Ashkar “ We DO Whatever It Takes “ Award?

Brenda Ashkar’s distinguished public health career in California spanned 37 years. She performed many roles within Los Angeles County’s efforts to eradicate TB and other diseases. Using leadership skills as a collaborative case manager, educator, and liaison, she worked effectively with every community and with all levels of health care providers. She also worked extensively with CTCA. This annual award honors a Registered Nurse who best exemplifies these qualities.

The award will be presented during the Awards Luncheon.

Who is eligible?

  • Registered Nurses in California, with at least 10 years experience in TB control
  • Available to accept the award at the conference
  • Has not previously received this award

Nomination

FROM:

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Name and title of person recommending nominee (please print)

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Organization (Please note each organization may nominate only one registered nurse per year.)

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Phoneemail

NOMINATING:

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Name, credentials and title of nominee (please print)

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Organization

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Number of years working in TB control and brief description of usual duties

Please describe why the California TB Controllers Association should honor this individual as the Outstanding Registered Nurse of the Year in Tuberculosis Control. Include examples highlighting your nominees contributions to TB prevention and control.

Please address the nominee's: 1) initiative and resourcefulness; 2) ability to effectively work as part of a team; 3) Leadership qualities; 4) commitment to ongoing TB education and training; 5) skills in working with TB patients and their communities; and 6) other outstanding qualities.

Your submission should be 500 words or less. Use an additional sheet if necessary.

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Scoring of Nominations:

In each category, scores will be given from 1-10, based on a subjective assessment of the example provided, for a total of 50 points.

  1. Initiative and resourcefulness
  2. Ability to work effectively
  3. Leadership qualities

4. Commitment to ongoing TB education and training

5. Skills in working with TB clients and their communities

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COMPLETED APPLICATIONS MUST BE RECEIVED BY NOON PTMarch 18

EMAIL/Fax form to / (888) 535-2822 with subject “Brenda Ashkar Award Nomination”Fax: (888) 535-2822(If you don’t receive an confirmation email from Judith, call her at 510-479-6139.)