Award Category: ___________________

Nominee for the award ______________________________

Nominee's address __________________________________

City/State/Zip Code__________________________________

Phone/E-mail ________________________________________

Nominator's name ______________________________________ (Must be active Sigma Theta Tau member)

Nominator's Signature: _____________________________________

Nominator's Contact Information (Phone/E-mail) _____________________

A statement of 50 words or less why you believe this person is deserving of the chosen award/scholarship.

_______________________________________________________________________

______________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

*For these awards, Nominees must have an active Sigma Theta Tau membership