Sigma Theta Tau International Nurse Leader Form

The purposes of Sigma Theta Tau International are:
1) Recognize superior achievement
2) Recognize the development of leadership qualities
3) Foster high professional standards.
4) Encourage creative work.
5) Strengthen commitment to the ideals and purposes of the profession

CRITERIA: Nurses must be registered nurses, legally recognized to practice in their country with a minimum of a baccalaureate degree or the equivalent in any field, and have demonstrated achievement in nursing.

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Name Name * First Last
Phone Phone - ### - ### ####
Email
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Former Education
List highest degree first, and one degree per line *
Attach a copy of documentation for the highest degree received *

Attach Files
Please check areas of achievement in nursing:

Please check areas of achievement in nursing: Administration Education Practice Publication Research Other Other
Please list your most recent (last five years) contributions to nursing in areas checked above. *
Final Submission *
Under the provisions of the Family Educational Rights and Privacy Act of 1974, I grant access to my academic record to the Chapter Eligibility Committee chairperson for consideration of my membership to Sigma Theta Tau International.

Draw your signature below *

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Full Name

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Signature Date Signature Date * / MM / DD YYYY
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