Top Nurses Form

Top Nurse Information Form

Congratulations! You’ve been nominated as a Delaware Today Top Nurse for 2025. Please complete the following information as it should appear in the May issue. We request personal email/phone/home address information so that we can send you an official notification if you are a winner, along with information about our Excellence in Nursing event (also in May). Mail sent to larger healthcare systems often gets lost. Your personal contact information will not be included in the magazine nor will it be shared with any other person.

Name(Required)

First Last

Phonetic Spelling / Pronunciation

Job Title(Required)

Nursing Certifications(Required)

(Please list all of your current credentials in the order they should appear in print.)

Current Employer(Required)

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Category of Nomination(Required)

Home Phone(Required)

Mobile Phone(Required)

Personal Email(Required)

Do you consent to having your nomination shared with your employer?(Required)

Yes