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Distinguished Alumni Nomination Form

Universityof Wyoming School of Nursing logo

Your recommendation must support at least one of the following criteria:

Contributions to the nursing profession, including excellence in clinical practice, education, administration, and research
Outstanding contributions to the community
Leadership in professional organizations

Important note:

Our school will contact you - the nominator - to request that you provide a resume for your nominee and at least one other support letter in addition to your letter (and not more than three letters). The more material we have on your candidate, the easier it is to make a clear, fair decision for this award. Thank you for taking the time to give recognition to an inspiring individual!

Please answer all questions below.

Nominator: Please type your full name: *

Nominator Contact Info: Please type your email address below: *

Name of person you would like to nominate (First, Last Name and Credentials): *

UW Nursing program from which your candidate graduated (if known) (MS FNP, MS EDUC, MS PMHNP, BSN, RN/BSN, or BRAND):

Year Candidate graduated from UW program (if known):

Candidate Mailing Address:

Candidate Phone Number:

Candidate Email Address:

Recommendation Letter Criteria - please check at least one: *
Contributions to the nursing profession, including excellence in clinical practice, education, administration, and research Outstanding contributions to the community Leadership in professional organizations
Recommendation Letter Transmission - choose how you intend to deliver your recommendation letter by the February 1 deadline.: *
Email letter to uwnursingalumni@uwyo.edu Mail letter to ATTN: Claire Hitchcock / UW School of Nursing / Dept 3065 / 1000 E. University Ave / Laramie, WY 82071 Deliver letter by hand to Claire Hitchcock at 351E Health Sciences Center Type recommendation into this form in space provided below
If you want to type your recommendation in this form, do so in the box below.:

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Distinguished Alumni Nomination Form

Your recommendation must support at least one of the following criteria:

Important note:

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