THE PHILIPPINE NURSES ASSOCIATION OF METROPOLITAN HOUSTON

OUTSTANDING FILIPINO NURSE AWARD

NURSING EXCELLENCE 2009

The Outstanding Filipino Nurse (OFN) Awards Program was established to honor Filipino nurses who have made outstanding contributions as professional nurses in any specialty, community service volunteers, or as healthcare business owners.

 To qualify for the award, the applicant must meet criteria for his/her specialty area. (See attached).  Any Filipino-American Registered Nurse who is currently licensed to practice in the State of Texas. Anyone may nominate a RN from any clinical specialty, however self-nomination will not be eligible. The Nominee must sign the nomination form to provide consent to be nominated.  All applicants are handled by the Scholarship and Recognition committee and the selection process is done based on established criteria. Initial screening will be completed by the committee. Final selection will be made by the same committee through a blind review of nominations.  OFN awardees will be honored at the annual PNAMH Nursing Award Gala in conjunction with the Nurses’ Week Celebration, on Saturday, May 2, 2009 at Mariott Houston Westchase 2900 Briarpark Dr. Houston TX. 77042 713.978.7400   Please submit all required documents in a folder or binder  Nominee must be an Active Member of PNAMH

1 PHILIPPINE NURSES ASSOCIATION OF METROPOLITAN HOUSTON 2009 Outstanding Filipino Nurse Award

NOMINATION FORM

Nominee: ______

Address: ______

Telephone# (H) ______(W) ______

Present Position: ______

Employer: ______

Business Address: ______

Justification:

In more specific terms, please indicate why you think your nominee deserves the award. Indicate only the significant achievements and outstanding contributions of the nominee in the particular award category using the criteria as guideline. Include documentation of achievements or letter of recommendations. Submit a CV or resume and a 2x2 photograph.

Nomination:

I wish to nominate the person mentioned above for the award as indicated.

Signature of Nominator: ______Date: ______

Address: ______

Telephone # (H) ______(W) ______

Attestation:

2 I attest to all facts in this form and give permission for said facts to be verified and/or used for publication. If selected, I will attend the awards ceremony to be held on Saturday, May 2, 2009 at Mariott Houston Westchase 2900 Briarpark Dr. Houston TX. 77042 713.978.7400

Signature of Nominee: ______Date:______

PHILIPPINE NURSES ASSOCIATION OF METROPOLITAN HOUSTON

2009 OUTSTANDING FILIPINO NURSE AWARD

CRITERIA

Member of PNAMH: YES _____/#of years______NO ______

Contributions to Clinical Practice/ Patient Outcomes:) As Nurse Entrepreneur, Administrator, Educator, Nurse Clinician, Nurse Researcher. (150 words min) ______

Leadership in Nursing Profession: ) As Nurse Entrepreneur, Administrator, Educator, Nurse Clinician, or Nurse Researcher. (150 words min) ______

3 ______

Community Services within the past year: (150 words min) ______

Awards, Recognitions, and Commendations: ______

Certifications:)

Publications, Lectures, and Presentations: ______

4 Membership to other Professional Organizations: ______

Use extra sheet if needed.

Deadline for submission: March 31, 2009 Check for completion of documents:

_____ Nomination Form ______CV/ Resume ______2x2 photo

_____ Narrative explanation ______Proof/documentation of accomplishments

_____Copy of current PNAMH Membership Card

NOTE: Incomplete Nominations and those received after March 31, 2009 will be disqualified!

Please Send All Forms to: PNAMH Scholarship and Recognition Awards Committee

Grace Diaz-Font 13559 Pasa Robles Ln Houston, Texas 77083 Phone: 281-568-3153

5 6