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NOMINATION FORMKim Williams General Medicine Scholarship
Awarded to a Registered or Enrolled Nurse who is recognised by their peers, as someone who embodies the spirit of nursing and the promotion of education.
Please complete ALL sections of the nomination form.
Nomination forms must be submitted on or before Thursday 24 March 2016
Completed nominations should be emailed to [email protected]
NOMINEE DETAILS (Their details)
Full name:
Current role:
Service area:
Email address:
NOMINATOR DETAILS (Your details)
Full name:
Service area:
Contact phone number:
Tell us why you are nominating the nurse, please include something in each of the appropriate sections.
Is professional, proud to be a nurse in General Medicine, raises the profile of nursing and models the Auckland DHB values
Provides a high standard of education to staff, patients and families
Fosters the development of professional knowledge and practice
Supports their nursing colleagues by mentoring and preceptoring
Any other comments
(Maximum word count: 200 words for each section)
