2026 Nurse of the Year Award Nomination Form

Phone

This field is for validation purposes and should be left unchanged.

NOMINATION PROCEDURES: Complete this form and submit it by clicking on the “submit” link at the bottom. Before you send the email, attach any supporting documents you wish to be considered by the judges. You are allowed up to 10 pages of supporting documents, and these should be submitted in the form of PDFs.

PURPOSE: This award recognizes a licensed or registered nurse working full time as a nurse in a member nursing home who demonstrates outstanding compassion, leadership success, innovation, achievement, and clinical excellence in the provision of high-quality, resident-centered care.

ELIGIBILITY: Must be a nurse in a member nursing home, including LPNs and RNs.

This form may be completed by either the nominee or the individual submitting the nomination.

Person Completing This Form:*

Email of Person Completing This Form:*

Name of Nominee:*

Title:*

Facility/organization:*

Address:*

Street Address Address Line 2 City State ZIP Code

Nominated By:*

Title:*

Facility:*

Address:*

Street Address Address Line 2 City State ZIP Code

I have confirmed that the nominee plans to attend the Annual Convention & Trade Show with his/her facility.*

Yes
No

List two media outlets that should receive a press release about this nomination.*

Major achievements:*

Leadership, supervisory, and teamwork skills:*

Where innovation has been employed:*

Give specific examples of how the nominee shows outstanding compassion.*

Describe how this nominee demonstrates clinical leadership in resident care and staff oversight.*

Describe how the the nominee displays personal leadership and dedication to residents and staff.*

Recognitions, honors, and awards:*

Additional Supporting Files:

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 5 MB, Max. files: 10.

Accepted Formats: PDF, DOC, DOCX | Max # Files: 10 | Max File Size: 5MB

THCA/TNCAL Convention & Trade Show