Nursing Excellence Award- Community Service
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Nominee Information
Nominee First Name *
Nominee Last Name *
Was Nominee a New Mexico resident 9/1/2021-8/31/2022? *
Nominee Employer/Organization *
Nominee Job Title(s) *
Nominee Email Address (for tickets, etc) *
Nominee Home Mailing Address (we send a congratulations letter)
Nominee Street *
Nominee City *
Nominee State *
Nominee Zip Code *
Nomination Category *
Nominator Information
Nominator First Name *
Nominator Last Name *
Nominator's Business/Organization/Affiliation *
Nominator's Email *
Nominator's Phone *
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