Local Chapter Excellence Award Nomination Form

Candidates for this award must meet the following criteria:

An APHON Chapter in good standing.
Has not received the award previously within the last 3 years.
Submitted all required paperwork to APHON headquarters.
The chapter demonstrated outstanding contributions within the pediatric hematology/oncology profession.
Create strategies to recruit and retain national and local chapter APHON members.
Create an environment that encourages the participation of all segments of the membership.
Increase APHON’s presence and contributions to the profession.
To develop educational opportunities, programs, and/or products.

Completed nominations must be submitted by June 30.

Local Chapter Excellence Award Nomination

Chapter Name(Required)

Chapter President

First Last

Chapter Vice President

First Last

Chapter Secretary

First Last

Chapter Treasurer

First Last

Number of chapter members

Number of APHON national members in chapter

Nominator Contact Information

Name(Required)

First Last

APHON Member ID

Nominator Email(Required)

Nominator Institution

What strategies has your chapter used to recruit and retain members to APHON? Please include dates for all activities.(Required)

What strategies has your chapter used to encourage participation of local chapter members?(Required)

Please list examples of how the chapter demonstrates significant contributions to the pediatric hematology/oncology nursing profession.(Required)

Please list educational opportunities, programs, and products that your chapter has participated in during the past year.(Required)

Upload supporting documents, if applicable

Max. file size: 160 MB.

Upload any exciting chapter photos. By uploading photos, you give APHON permission to use the media for announcements of awards (member connections, emails and social media.)

Drop files here or

Max. file size: 160 MB.

Comments

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