The Greater New York March of Dimes

March of Dimes New York State Chapter

37th Annual Perinatal Nurses Conference

Perinatal Health: Redefining Collaboration for the 21st Century

Monday, March 23, 2015

Crown Plaza – White Plains-Downtown – 66 Hale Avenue, White Plains, NY 10601

2015 Maternal Child Health Nurse Award for Clinical Excellence

Nomination Guidelines

The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. The March of Dimes strives to improve the quality and accessibility of prenatal care, to bring more women into prenatal care, and to promote healthy preconception and prenatal behaviors.

In recognition of the crucial role that nurses play in maternal and child health care, the March of Dimes New York State Chapter presents annually an award of $500 to a nurse demonstrating clinical excellence. In the event that two recipients are selected, the prize money is divided equally.

Eligibility for nomination:

The nominee must be a Registered Nurse actively involved in caring for the needs of mothers, babies, and families in New York State. The nominee must have at least three years of current clinical experience in MCH nursing at the time of the nomination.

CRITERIA FOR NOMINATIION:

The nominee should be a nurse who:

WHO MAY NOMINATE: Anyone may nominate a nurse for the award.

NOTIFICATION: The chapter’s Nurse Advisory Committee will review all applications and notify the nominees of their decision in early March 2015. The award will be presented at the 36th Annual Perinatal Nurses Conference during a luncheon in the awardee’s honor. The luncheon will be held on Monday, March 23th, 2015, at the Crowne Plaza White Plains-Downtown, 66 Hale Avenue, White Plains, NY 10601.

Please send nomination form and the candidate’s CV. Deadline for submission is Friday, February 13, 2015 and due by 3:00 pm:

Submission of the nomination by e-mail is acceptable. All applications MUST BE TYPED,

handwritten nominations will not be reviewed.

You can request an email version of the nomination by emailing:

Madeline Britt, Statewide Program Coordinator

March of Dimes, 515 Madison Avenue, 20th Floor, New York, NY 10022

uTel: (212) 353-8267 uE-mail:

Nomination Application

Deadline for Nominations: Friday, February 13, 2015 and due by 3:00 pm

You must submit the nominee’s CV with the completed nomination form.

Attach additional pages as needed. Please type - email submissions are accepted.

NOMINATOR

Name: ______

Title: ______

Institution/Affiliation: ______

Address: ______

______

Phone: ______

Fax: ______Email: ______

Signature: ______

NOMINEE

Name: ______

Title: ______

Institution/Affiliation: ______

Address: ______

______

Phone: ______

Fax: ______Email: ______

On an attached page, please describe how the nominee meets the criteria for the MCH Nurse Award for Clinical Excellence. Please include any other information about the nominee that you think we should know. Note: Each nominee may not meet all the criteria and this should not discourage the nomination.

Thank you.