Request Information about the DAISY for Academic Programs

For more information about The DAISY Award for Extrordinary Nursing Sturdents and/or The DAISY Award for Extraordinary Nursing Faculty, please fill in the information below, and click Submit. We will email you a letter of introduction and FAQs about the program(s) of your choice. We look forward to hearing from you!

DAISY for Academic Programs

Information request: You may click one or both

I would like information about

DAISY Faculty Award

I would like information about

DAISY Award for Extraordinary Nursing Students

Name of Academic Institution - College or School of Nursing

Street Address of Academic Institution

City of Academic Institution

State of Academic Instituion

Zip code of Academic Institution

Website Address of Academic Institution

What is your academic calendar?

Approximate Number of Nursing Faculty

Approximate Number of Nursing Students

Your Contact Information

First name

Last name

Credentials, if appropriate

Title, if appropriate

Email Address (janesmith@univ.edu)

Phone Number (555-555-1212)

Mobile Phone Number (555-555-1212)

Are you currently a Nursing Student?

Are you an Officer or active Member of a Student Nursing Organization or Honor Society? If yes, please list:

How did you hear about The DAISY In Training Award and/or The DAISY Faculty Award?

Is there anything else we should know?

Are there others who should receive information about The DAISY In Training Award and/or The DAISY Faculty Award?

(E.g. Dean of Nursing, Associate Dean, Dean of Academic Affairs, Department Chair, Clinical Instructor, Professor of Nursing, Director of Nursing)

Additional Contact First Name

Additional Contact Last Name

Additional Contact Title, if appropriate

Additional Contact Phone (555-555-1212)

Additional Contact Email (janesmith@univ.edu)

Acknowledgement

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Request Information about the DAISY for Academic Programs