National Student Nurses’ Association, Inc.
Giving Credit Where Credit Is Due
Attention School and State Leaders-if you are:
- a senior graduating in April/May/June or December /January and
- you have received school/class credit for your participation in NSNA activities at the school, state and/or national levels
You are entitled to receive an NSNA Leadership U Recognition Certificate!
Please complete and FAX this form two weeks prior to annual convention
to (718) 797-1186
NSNA Leadership U awardees will be asked to stand to be recognized at the Awards Ceremony on Thursday evening.
NSNA Leadership U Certificate Request Form (incomplete forms are not honored)
NSNA membership number______________
Expiration date________________________
Name (Print name clearly on the line below in block letters using black ink):
______________________________________________________________
Expected date of Graduation________
School of Nursing_________________________________________
A member of your school faculty or the dean/director must complete the information below and sign this form.
Faculty name (print)___________________________________________
Statement: The above named student is enrolled in the school of nursing and is expected to graduate on the date indicated. This verifies that this student received school/class credit for their participation in NSNA.
Signature______________________________
Title:_________________________________
Faculty Phone:__________________________
FAX: ________________________________
e-mail:________________________________
Questions??? send an e-mail to nsna@nsna.org
or call NSNA at (718) 210-0705 |