- Involvement in CANNT - Clinical Experience - Describe course of study - Demographic information of teaching institution including name of program - Expected date of completion - Explain how this course will be used to enhance nephrology practice - Certified in Nephrology (year) - List any verbal presentations/posters/publications - Involvement in leadership projects

- Practice (years in nephrology, preceptorship, technical teacher, charge nurse, education) - Continuing education activities - Certified in Nephrology (year certified) - Involvement in CANNT - Participation in other professional associations - Presentations or publications - Involvement in leadership projects

→ Goals and objectives of the study → Methodology used → Description of the potential benefits of the study to the practice of nephrology nursing, technology or patient care → Describe the projected timeline

The names (and possibly portions of the application) of the selected winners will be published in the CANNT Journal and on the CANNT website. The nomination forms and content become the property of the CANNT Association and will only be used to promote professional nephrology excellence to its membership.