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ASPMN Distinguished Service Award
Please complete the application below, including uploading additional required attachments.
Name of Nominee
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First
Last
Academic/Professional Credentials
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Title
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Employer
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Phone
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Email
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Nominee is a current ASPMN member.
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Yes
No
ASPMN Involvement:
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List Board or committee involvement.
Leadership and contributions to pain management nursing have been demonstrated by:
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Leadership and contributions to the goals of ASPMN have been demonstrated by:
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Attach a copy of nominee's current CV
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Letter of Recommendation
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Letters of recommendation should not exceed two pages.
Nominated by:
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First
Last
Phone
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Email
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