Membership/Induction Information

Induction of new members occurs in the Fall.

Community Leader

Definition: Criteria

Nurses with a minimum of a baccalaureate degree who have demonstrated marked acheivemnet in education, practice, research, administration or publication.

Name: ______________________________________________________ 
                        Last Name                                         First Name 

Address: ______________________________________________

_____________________________________________________

Phone Number: _________________________________________

Former Education: (List all degrees and attach a copy of documentation of BS or MS nursing degree.) ______________________________________________________

______________________________________________________
Candidate signature and Date

Please check areas of achievement in Nursing:  

_____  Education	_____ Administration
_____ Practice	_____ Publication
_____ Research	_____ Other (Please indicate)

Please attach a list your most recent (last five years) contributions to nursing in areas checked.

Please attach to this form two letters of endorsement from active members of Sigma Theta Tau International.