THE NIGERIAN NURSING EXCELLENCE AWARD LAGOS, NIGERIA 2009 Application Form Return No Later than February 20, 2009
This form must be completed and returned to the Event Manager, Nigerin Nursing Excellence Award, 3rd Floor, Nwaora plaza, No 3, Dar es Salaam Street, Off Aminu Kano Street, Wuse 2, Abuja or by email to crhaids@yahoo.com on or before 5pm on February 20th 2009. All referees letters must be submitted separetly by the referees. Please note that all applications must be typed, double spaced and type font must be 12.
GENERAL INFORMATION
How many years of clinical nursing experience do you have?
List of responsibilities on your current job:
Summary of detailed educational background:
Summary of anything you feel would be important for the selection committee to know:
How did you hear about this program?
Explain why you are applying for this award and how you expect it to contribute to your professional development (in not more than 150 words).
What challenges do you think face the Nursing practice in Nigeria (in not more than 250 words)
What would you do to improve the image of nursing practice in Nigeria? (in not more than 150 words)
Please give the names of two referees, one other than your employer, who are knowledgeable about your work.
a) Name: Organisation: Telephone: Email:
b) Name: Organisation: Telephone: Email:
Declaration: I hereby declare that the information given in this application is correct to the best of my knowledge.
Date:
Signature of Applicant:
