BAINA Award Nomination Form | Bay Area Indian Nurses

Type of Award (Select one from the dropdown menu)

Nominee Information

First Name

Last Name

Credentials

Licensure Type

Street Address

City

State/Province/Region

Zip Code

Country

Phone

Current Nursing Position

Nominator Information

First Name

Last Name

Credentials

Licensure Type

Street Address

City

State

Zip Code

Country

Phone

Nonimator Email

Current Nursing Position

Relationship with Nominee

Narrative Statement

Please provide a narrative statement (maximum 300 words) that highlights the nominee's qualifications related to the selected award category. Do not include the nominee's name in this statement. Ensure that your response demonstrates how the nominee advances BAINA’s vision, mission, and values.

Narrative Statement (doc, docx, pdf, rtf) (5MB max size)

Attachments

Please attach the following documents and ensure all attachments are in PDF or Word format and do not exceed 5MB in total size.

CV/Resume of the Nominee (doc, docx, pdf, rtf) (5MB max size)

Presentation/Material related to the Narrative Statement (as applicable) (doc, docx, pdf, rtf) (5MB max size)

Recommendation Letter from another source (doc, docx, pdf, rtf) (5MB max size)

Submission Confirmation

Upon successful submission of this form, you will receive a confirmation email. If you do not receive a confirmation, please check your spam folder or contact us for assistance.

Deadline for Nominations

Please submit your nomination by October 6th, 2025.

Thank you for your commitment to recognizing excellence in nursing through the BAINA awards! Please reach out to us, if you have questions at bainaphilanthropy@gmail.com

Success!

Thank you for your commitment to recognizing excellence in nursing through the BAINA awards!

Please reach out to us, if you have questions at bainaphilanthropy@gmail.com.