Nursing Student
Image of Nursing Award
School Name: _____________________________________________________________________
School Address: ___________________________________________________________________
City: ____________________________________ State: ____________ ZIP: ______________
Phone: _________________________________ Fax: __________________________________
Chapter President: ________________________________________________________________
Chapter Advisor: _________________________________________________________________
Title of Project: ____________________________________________________
Dates(s) of Project: ________________________________________________
Site(s) of Project: __________________________________________________
PLEASE INCLUDE THE FOLLOWING:
(may include another sheet of paper for additional space)
List the goals of the project and explain to what extent the goals were accomplished:
Number of nursing student involved: _________________
Number of people attending (if applicable): ____________
If non-nursing students colaborated, describe:
Will this project be continued next year by your association? Yes No
Attach any publicity of other material used to advertise the project
(i.e., photos, flyers, press releases, tapes, ect.):
Describe how the project was promoted in all forms of the media.
Chapter Advisor's Signature: _________________________________________
Date: _____________________________
September 10, 2004
GANS Awards Committee
c/o Traci Steinhauser
1727 Country Park Way
Lawrenceville GA 30043
(404)432-7273
[email protected]