Salute To Health Care Awards Luncheon The Overlook July 15, 2014 11:30 am
Nomination Form Nurse of the Year and Health Care Professional of the Year Who Can Be Nominated? Any nurse or health care professional, who, through their individual or collective actions, has made an extraordinary impact in the Lake Houston Area health care community. Their acts of service will represent a display of dedication to excellence in their area of expertise beyond the scope of their jobs. Through their commitment to their profession and community, they serve as an inspiration to others in an effort to improve the quality of health care and discover new ways to assist those in need. I AM NOMINATING: ____NURSE ____HEALTH CARE PROFESSIONAL (Physician, Dentist, Health Care Administrator, etc.)
Nominee Information Name_____________________________Title___________________________ Organization______________________________________________________ Address, City, Zip__________________________________________________
Presenting Sponsor:
Platinum Sponsor: Texas Emergency Care Center Award Sponsor: Bank of Houston/Kingwood Gold Sponsors: Humble Dreams Sleep Center Kingwood Pines Hospital Memorial Hermann Northeast Total Body Boutique
Phone_____________________Email__________________________________ Please submit the following: 1. Attach a brief description of the nominee’s achievements and contributions. Explain how these achievements go above and beyond the scope of the nominee’s job. Your explanation of why your nominee should be chosen will be a primary consideration of the final decision. 2. With reference to your nominee, attach to this application a list of activities, programs, in-kind contributions, etc. that directly benefited the community.
YOUR Name________________________Title___________________________
Reservations: $25 for Chamber Members $30 Guests
For more info or to RSVP: 281-446-2128
LakeHouston.org
YOUR Organization_________________________________________________ YOUR Address,City,Zip______________________________________________ YOUR Phone________________Email__________________________________ Relationship to the Nominee: _________________________________________ ____________________________________ Signature
All Nominations Must Be Received By The Chamber Office No Later Than 5 PM, June 16, 2014. Fax to: 281-446-7483 Email to: jarmstrong@lakehouston.org Mail to: Lake Houston Area Chamber, 110 W Main Humble, TX 77338