Preceptor Recognition

Nomination Form

Thank you for your willingness to nominate your awesome preceptor! Answering the last question, please give examples, fully describe why you are nominating the preceptor and how they are helping you meet your clinical objectives.

Please answer all questions below.

Please don't fill out this input box.

Program:*

Basic BSN

BRAND

RN/BSN Completion

FNP

PMHNP

Name of Preceptor you wish to nominate:*

Agency where the Preceptor works:*

Preceptor Specialty (for example, ER, Women's Health, Pediatrics, ICU, etc.):*

Preceptor Email Address:*

Nominator (Your Name!):*

Your E-mail Address:*

Semester of Submission (Spring 2013, Summer 2013, etc.):*

Why I am nominating the above preceptor for special recognition (please describe fully!):*

Contact Us

Fay W. Whitney School of Nursing

Health Sciences Building

Room 351
1000 E. University Ave
Laramie, WY 82071
Dept. 3065
Fax: (307) 766-4294
Email: uwnursing@uwyo.edu
Phone: (307) 766-4312

The University of Wyoming has earned its Research Level 1 (R1) status from the Carnegie Classification of Institutions of Higher Education, placing Wyoming's only four-year university with the top research universities in the United States.