CALIFORNIA SCHOOL NURSES ORGANIZATIONSCHOOL NURSES OPTIMIZE HEALTH AND ENHANCE LEARNING

EXCELLENCE IN SCHOOL NURSING ADMINISTRATOR APPLICATION

PURPOSETo publicly recognize and annually honor California school nurse administrators who leads, manages, and coordinators quality school nursing services and school health programs.

SPONSORSHIPCalifornia School Nurses Organization

DUE –NOVEMBER 1All applications must be submitted on the CSNO Website under awards section for State consideration by November 1.

Nominee must be: 1. A credentialed school nurse; 2. A member in good standing of CSNO/NASN for the preceding FIVE years;3. Currently practicing as a school nurse administrator;4. Responsible for supervising, administrating and coordinating school nursing services and

school health programs.5. Able to document evidence of excellence in school nursing administration based on Scope

and Standards for Nurse Administrators,3ed (American Nurses Association).

  Procedure for Submission of Application*1. Complete the information below2. Provide a 1-2 paragraph bio, which will be used in the CSNO State Bulletin.3. Provide a 1 page Resume or CV4. Provide a high resolution digital photo5. Provide a 300 word summary of accomplishments as a school nurse 6. Address the Scope and Standards of Professional School Nursing Practice; no more than

300 words per Standard. *Upon submission of all applications and depending on the quality of applications, the CSNO State Board reserves the right to select one section nominee to represent California in the NASN State Affiliate Award. It is recommended that all candidates develop a portfolio of the above contents to be submitted to NASN.  Additionally, the NASN candidate will be required to submit two letters of recommendation with their NASN submission.

Excellence in School Nursing Criterion-No more than 300 words per criterion.

As a School Nurse Administrator, at the health services or organizational level, please describe how you have: 1. Fostered education, health promotion, and teaching;2. Championed collegiality, collaboration and resource utilization3. Promoted research, quality of and professional practice and ensuring ethical standards; 4. Engaged in optimal leadership and advocacy practices.

CALIFORNIA SCHOOL NURSES ORGANIZATIONSCHOOL NURSES OPTIMIZE HEALTH AND ENHANCE LEARNING

Name of Nominee and Credentials ______________________________________Nominee's Home Address _____________________________________________City, State and Zip Code______________________________________________Phone Number (H)___________________ (W) ____________________________Cell ______________________________E-mail___________________________

Employer __________________________________________________________Address ___________________________________________________________Supervisor & Title___________________________________________________ Superintendent______________________________________________________Phone_____________________________________________________________Address____________________________________________________________

Present Position _____________________________________________________Number of years in position ___________________________________________Position Full Time YES ___ NO ___Supervisor of health? Or School health administrator? YES ___ NO ___Member of CSNO/NASN, current and preceding years YES ___ NO ___

Please sign and date below

I, ____________________________________, certify that the information in this document is accurate and that I am an active member of CSNO/NASN. It is my understanding that if any part of this application is incorrect it could jeopardize my participation in the State and National Recognition for the School Nurse of the Year.

Date Signature