Massachusetts School Nurse Organization, MSNO School Nurse Administratior Recognition Award Application

Massachusetts School Nurse Organization, Inc. School Nurse Administrator of the Year Award 2007 - 2008
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General Instructions

The following application (Parts A and B) is to be completed by the nominee, a colleague or supervisor. Please omit reference to the nominee's name or place of employment in the text. Kindly cite each number/letter below with the appropriate response.

Maximum: three pages. Please note: Application must be typed. Please print and forward the completed application to Janis Townsend at the address listed below:

Send application to:
Janis Townsend (MSNO awards committee chairperson)
31 Harwood Road
Natick, Massachusetts 01760

Application Deadline: April 30, 2008.

Please feel free to contact Janis Townsend (MSNO awards committee chairperson) at townsend@msno.org.

PART A

Name and title of person completing the nomination form:

Nominee's Name:

Home Address:

Phone (area code):

Town:_________________________________Zip Code:

School District:

School Address:

Town:_________________________________Zip Code:

School Phone:

Name of Supervisor_______________________Name of Principal:

Briefly list the nominee's educational preparation for nursing. Include reference to school(s) attended and any formal education/certification programs completed.

PART B

The following part of the application is to be completed by the nominee, a colleague, or supervisor. Please omit reference to the nominee’s name or place of employment in the text.

Administrative qualities that promote school health services

Effective management of school health program through priority setting, decision-making and work organization.

Ability to utilize resources, both human and material, to improve school health program.

Leadership and/or participation in professional organizations at local, state and national levels

Legislative participation

Role in promoting nursing research

Selection Criteria

MSNO member for at least two years.

NASN member for at least 2 years.

Currently employed as a School Nurse Administrator.

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