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Leadership In Action Award Nomination
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Nominations are Due August 31

Nominations must be submitted online using the application form below.

Note: Self-nominations are acceptable.  



 Jan 1 – Aug 31:   Applications Accepted
 Aug – Sep:   Interviews Conducted
 Oct 1 – 15:  Selection Committee Meets
 Oct 31:   Nominees Notified of their Status
 November  Finalists Recognized at AzONL Conference



Nominees are expected to meet all of the following criteria:

  • Currently licensed as a Registered Nurse in the state of Arizona, member of a professional nursing organization and currently hold a Bachelor’s or higher nursing degree.
  • Significantly or uniquely contributes to leadership (does not need to be in a formal leadership role).
  • Demonstrates leadership in community affairs, nursing professional organizations, and in the growth and development of others in these areas.
  • Positively promotes and advances the nursing profession in the community (locally or globally) through volunteerism and/or outreach efforts.

In addition to the required response statements, Nominees will be required to provide a high-resolution digital photo of themselves and a current CV. 


Online Application Components & Instructions


The online form has the following components:

  • Nominee Contact Information
  • Nominee Title and Place of Employment
  • CV (uploaded as a PDF document)
  • Biographical Statement (100 words – entered directly into the form) 
  • Photo (uploaded as a high resolution – minimum 300dpi JPG or PNG file)
  • Response Statement (500 word maximum) describing Nominee’s contributions, efforts and outcomes (entered directly into form) – see further guidance below.
  • If self-nominating, please include a letter of reference from an individual (not related to you) who is familiar with your efforts as a Nurse Leader (uploaded as a PDF file).  

Note: After completing and submitting the nomination form, you will be provided with a confirmation email which contains a link to provide your availability for an Interview Time (15 minute block) during the months of August and September.  The Interviews will take place via Computer (Skype; Zoom; Google Hangouts, etc.)  


Response (Statement) Guidance:

5,000 character limit with spaces (about 500 words) – the form will advise if you are over the limit.

Please provide a statement (written in the third person) that includes the following as applicable:


1.  Describe specific example(s) of significant or unique contributions the Nominee has made to the nursing profession through leadership in any or all of the following ways:

  • Maintains curiosity and eagerness to explore new knowledge and ideas.
  • Promotes nursing leadership as both a science and an art.
  • Considers the impact of nursing decisions on the health care organization as a whole.
  • Serves as a change agent, assisting others in understanding the importance, necessity, impact and process of change.

2.  Provide information which describes specific contributions the Nominee has made to the nursing profession by providing leadership in the specific category for which they are applying.


Third Person Format Example:  As a Nurse Leader, Nominee’s First Name maintains curiosity and eagerness to explore new knowledge and ideas.  She/He promotes nursing leadership as both a science and an art. 


Tips for Completing the Form

  1. Review the form, fields and required items to be submitted prior to completing the form.  Prepare the components ahead of time in a document and then plan a block of time where you will have uninterrupted access to a computer with internet (minimum 15 minutes to complete the form and upload the components).
  2. If you encounter difficulty with the online form, please contact the AzONL Office at 480-491-5627.
  3.  Cite specific examples in your answers and address as many of the areas defined in the Criteria for Selection as possible.
  4. For fields requiring a long response, craft your response in a word or text document and then “cut and paste” the text into the field. 


This is the person being nominated for the award.

If you are nominating someone for this award, complete this information. If you are self-nominating, you may leave these fields blank and then please upload a reference letter where indicated.

1000 of 1000 characters remaining
5000 of 5000 characters remaining
By selecting YES below, you are attesting that you are either self-nominating yourself for this award or you are nominating someone for this award and that you believe the above information is true to the best of your knowledge. If you are nominating someone for this award, you further attest that you have the permission of the individual to nominate them for this award.

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