2014 nominations are now open

Chicago (IL, WI, IN, IA, KY)2/7
Philadelphia 2/7
NY/NJ 2/14
Mountain West – (AK, NM, WA, OR, NV, AZ)2/28
Heartland/Florida/Texas/New England2/28
If you still have a nomination for a closed region, please give us a call to see about late submissions: 800-868-8944 x 5146

2014 Rising Star Nomination Form

Nominator Information
Your First Name*  
Your Last Name*  
Your Nursing Credentials*  
Your Employer  
Your Job Title  
Your Email*  
Your Telephone  

The nominator must be an RN who shares a professional relationship with the nominee and who is not a member of the nominee's family.


A RISING STAR is a nurse who has been licensed and working in any setting for fewer than five years and who:

  • Possesses a strong nursing knowledge base and good clinical practice skills
  • Shows special characteristics and traits that indicate future leadership roles
  • Understands the need and sets personal and career goals to achieve success
  • Demonstrates knowledge of current issues affecting nurses and the profession
  • Works collaboratively in nursing and interdisciplinary patient care groups
  • Participates in nursing meetings and organizations outside the workplace
  • Goes above and beyond his or her role to effect change and make a difference

Nominee's First Name*  
Nominee's Last Name*
  , Credentials* 
Nominee's Job Title*  
Nominee's Home Address*  
Nominee's Home Phone*  
Nominee's Home Fax  
Nominee's Email*  
Nominee's Work Phone*  
Nominee's Work Fax  
Nominee's Work Email*  

Nominee's Employer*  
Employer's Address*  
Employer's Phone*  

Nomination Questions
*Please Keep Total Responses to Under 1,000 words

Question #1

Using examples, discuss ways in which your nominee's performance has been outstanding or different from his or her peer group in these early years of practice.

Question #2

Cite some specific ways in which your nominee has gone "above and beyond" ordinary role expectations to show excellence as a developing clinician, leader or educator.

Question #3

Provide information regarding initiatives, programs, committees or organizational work your nominee has been involved in, or special awards received.

Question #4

Based on the above description of a RISING STAR, choose a point or two to tell the judges how and why your nominee shines!