2020 DISTINGUISHED ALUMNI AWARD NOMINATION FORM The Baylor University Louise Herrington School of Nursing seeks your nominations for the 2020 Distinguished Alumni Award. Nominees should exemplify scholarship, leadership and service as described in the following categories:

LEARN - Significantly or uniquely contributes to the nursing profession through clinical practice, education and teaching, administrative leadership, research, writing, publishing, and/or healthcare innovation.

LEAD - Demonstrates leadership in community affairs, nursing professional organizations, and in growth and development of others in these areas.

SERVE - Positively promotes and advances the nursing profession in the community through volunteering and/or outreach efforts.

The Distinguished Alumni Award will be presented at the Alumni Reunion on April 25, 2020. The deadline for receipt of your nomination is February 15, 2020. Please mail completed nomination forms to the address noted below.

NOMINEE INFORMATION

Full Name ______________________________________________________________________ Class ______________ Mailing Address _____________________________________________________________________________________ Phone Number ______________________________________________________________________________________ Email Address ______________________________________________________________________________________

NOMINATOR INFORMATION

Nominated by _______________________________________________________________________________________ Mailing Address _____________________________________________________________________________________ Email Address ______________________________________________________________________________________ Phone Number ______________________________________________________________________________________

REASON FOR NOMINATION

Please provide as much specific information as possible to indicate the ways in which your nominee meets these criteria. You may wish to solicit help from your friends or colleagues. The committee will also seek additional information on nominees when necessary.

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Return this form to: Tina Glaspie, 333 N. Washington, Dallas, Texas 75246 . Nominations are due by February 15, 2020. Recipients will be notified by March 1, 2020.

For more information, contact Tina Glaspie at (972) 576-9219 Tina_Glaspie@baylor.edu