Become a DAISY Ambassador

May we have your agreement to include you in our roster of DAISY Ambassadors and publish your name and picture on the Internet and in print and share this with other media and nursing education organizations for their publication?

If you select "No," please DO NOT SUBMIT THIS FORM.  

Tell Us about the Organization where you experienced DAISY: 

Tell Us About Yourself:

Please complete only the email address and phone number you wish to be posted on our DAISY Foundation website.

A few days after submitting this form, you will be notified when we have added you as a DAISY Ambassador on our website at  Please note: DAISY Ambassadors are listed by region of the United States.


Below is a step-by-step guide of the information we need you to provide:


Your DAISY Ambassador Quote

Please provide a quote about your DAISY experience.  Either Copy and Paste prepared text or, type the text directly into the box below.  This should be text-only.  Please do not include enhanced formatting embellishments (i.e. borders, etc.) or any images (i.e. a photo).  Use the re-sizing arrow in the bottom, right-hand corner to expand the box as needed.


Your DAISY Ambassador Photo


  1. Prepare a photo of yourself preferably in .jpg/.jpeg format.  Do not embellish the photo with frames, borders etc.  
  2. Please name your photo file as your First and Last Name with the word Photo. (E.g. Jane Doe Photo or Jane Doe group Photo) Please do not generically name your photo file as, for example, "DAISY Ambassador" or the "Month and/or Year" the award was presented.
  3. Please "compress for web" and save your photo file.
  4. Upload your photo file by clicking the choose file button in the Upload picture section below and browsing to where you have saved your photo file. 


If your registration form with a photo file attached cannot be processed, please try re-submitting the registration form WITHOUT the photo file.  Then, email your Quote and Photo file to  Please include UNABLE TO SUBMIT AMBASSADOR with your First and Last Name and the name of your organization in the subject of your email (for instance, "UNABLE TO SUBMIT AMBASSADOR Jane Doe, Hometown Hospital.")


Thank you for registering to be DAISY Ambassador!