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 and mail to Janis Townsend, MSNO Awards Committee Chairperson at the address listed below:


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 with any questions.

1. Cite specific examples and supporting comments to describe outstanding performances in three of the following areas:
   a. Expertise in school nursing practice.
   b. Effective management of school health program through priority setting, decision-making and work organization.
   c. Creative use of resources, both human and material, to improve school health program.
   d. Excellence in health teaching.
   e. Role in nursing research.
   f. Leadership and/or participation in professional organizations.
   
   
2. Describe one activity in which the nominee has actively participated within the past two years which had an impact on school nursing (i.e. preceptor, mentor, community activity related to school nursing, professional organization).
   
   
3. Cite and describe an example of how the nominee's professional behavior has influenced the image of school nursing.