American Society for Pain Management Nurses

Rising Star Award

Please complete the application below, including uploading additional required attachments.

The ASPMN Rising Star Award, established in 2020 by the ASPMN Board of Directors, is presented to a newer* pain management nurse in recognition of outstanding contributions to the field of pain management nursing as well as recognized potential future contributions.

First Name *

Last Name *

Email *

Name of Nominee: *

Nominee Academic/Professional Credentials: *

Nominee Job Title: *

Nominee Current Employer: *

Nominee Phone Number: *

Nominee Email Address: *

Is the Nominee a Current Member of ASPMN? *

Yes

Years of Practice in Pain Management: *

Nominee's ASPMN Involvement (List Board or Committee Involvement): *

If not addressed in the letter of recommendation, please describe how the nominee demonstrates the following:

1. Demonstrates the potential for leadership and outstanding contribution to the field of pain management nursing.

2. Demonstrates leadership in promoting excellence in pain care (ie. nursing practice, policy review/revision, education, evidence-based practice, research, role model for patient pain care/advocacy.) *

Letter of Recommendation (Letters of recommendation should not exceed two pages and should describe the nominees excellence and potential.): *

Nominee's Current CV: *

Nominated By: *

Nominator's Phone Number: *

Nominator's Email Address: *