Nomination Form

Distinguished Alumnus Award
Laura Rosnagle Alumnus Service Award

Criteria for the Laura Rosnagle Alumnus Service Award

  • Graduate of the University of Cincinnati College of Nursing
  • Has displayed unusual devotion and effort on behalf of the College of Nursing and its alumni organization

Criteria for the Distinguished Alumnus Award

  • Graduate of the University of Cincinnati College of Nursing
  • Has made a significant contribution to the nursing profession through clinical practice, teaching, administration, education, research, writing, organizational work involving health care or an innovation in health care
    OR
  • Has contributed significantly to the growth and development of the community

Please complete the following information. Prior winners of this award will not be reconsidered. If you are uncertain about your nominee's eligibility, please call the Alumni office at 513/556-4347.

Nominee Information   Nominator (person making nomination)
Nominee Name
   Nominator Name
Nominee Home Address
   Nominator Home Address
City        City     
State          Zip   State          Zip
Nominee Email   Nominator Email
Nominee Phone Class   Nominator Phone
 
Award (check one)

Distinguished Alumnus Award
Laura E. Rosnagle Alumnus Service Award
Nominees Place of Employment & Professional Experience
Nominees Professional Activities
Nominees Community Involvement
Do you know the nominee personally?



Describe the relationship
Reason nominee should receive award

Nominations must be postmarked by February 1, 2007.