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<p></p>
<center>New Jersey Association of Public Health Nurse Administrators

<p><b><u>Public Health Nurse Administrator of the Year<br>
Award Nomination</u></b></center>


<p><b><u>CRITERIA</u></b>

<p>1.  NJ Licensed RN. <br>
2.  Member in good standing of NJAPHNA. <br>
3.  Currently working as an administrator in Public Health Nursing. <br>
4.  Is a visionary and leader. <br>
5.  Is a teacher and role model. <br>
6.  Demonstrates expertise in the clinical nursing practice of public health. <br>


<p>Name of Nominee:  ________________________________<br>
<p>Telephone:  ___________________

<p>Please briefly describe how the nominee exemplifies the above criteria. <br>


<p>______________________________________________________________________________

<p>______________________________________________________________________________

<p>______________________________________________________________________________

<p>______________________________________________________________________________


<p>Your Name:  ____________________________________ <p>Telephone:  ____________________
 <br>

 <p>Return by October 22 to: <br> 
Kathryn A. Whitehead, BSN, RN <br>
Public Health Nurse Supervisor <br>
Hanover Township Health Department <br>
973-515-6668 <br>
 Fax:  973-515-3772<br>
KWhitehead@hanovertownship.com<br><br><br>


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