NAPNAP CH-12: NAPNAP Chapter Activites Form

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CH-12: NAPNAP Chapter Activities Form

CHAPTER ACTIVITIES (from previous fiscal year)

* Required Field

* CHAPTER NAME:

Directions: All answers should reflect activities in the previous fiscal year. Please select the most appropriate answer and/or fill in the short answers as indicated. Important: Both Section I AND Section II MUST be completed for consideration for the Annual Outstanding Chapter Award.

SECTION I

A.	Do you publish a chapter newsletter?
	*
	If yes,
	1. How often is it published?	*
	2. How is the publication funded?	*
	3. Do you send your chapter newsletter to the National Office?
	*

B.	Does your chapter have a website?
	*
	If yes, what is the www address?	*

C.	Does your chapter have a program in place to mentor students/new grads into chapter committees or leadership roles?
	*

D.	In the past 12 months, has your chapter developed and/or used a membership survey to determine demographics, employment characteristics, etc.?
	*
	If yes, have you shared the results with the National Office?
	*
	If no, why?
	*


E.	In the past 12 months, what were the two (2) most important professional practice issues your chapter dealt with (i.e., prescriptive authority, third party reimbursement, managed care, state nurse practice act, etc.)?
	1. *
	2. *

SECTION II

OUTSTANDING CHAPTER AWARD CRITERIA

NOW IS YOUR CHANCE TO SHINE!!! Please describe three (3) chapter accomplishments that you feel should be considered for the Annual Outstanding Chapter Awards.

DIRECTIONS

1. These accomplishments should reflect activities, issues and/or projects that the chapter addressed during the previous fiscal year.

2. Feel free to embellish upon those activities that were mentioned in Section I.

3. Please avoid any identifying information such as state name, etc.

4. You MUST limit the descriptions of each accomplishment to 200 words or less.

ANY DESCRIPTIONS ABOVE 200 WORDS WILL BE EDITED!!

1.

2.

3.

* Email address of person submitting this form