Pat Fredrickson Excellence in Leadership Award NOMINATION ...

Fredrickson-McGregor Education Foundation for LPNs
Pat Fredrickson Excellence in Leadership Award
NOMINATION PROCESS
The Award:
The Pat Fredrickson Excellence in Leadership Award is a $1000 cash award and commemorative crystal
award presented annually at the College of Licensed Practical Nurses of Alberta’s (CLPNA) Spring
Conference to the nominee who best displays excellence in leadership.
This Award was established to honour Pat Fredrickson, a woman of vision, leadership, and credibility
who served the LPN profession for over 40 years, including 20 years as the Executive Director/Registrar
of the College of Licensed Practical Nurses of Alberta. Pat is recognized as being instrumental in
bringing recognition and value to the role of the LPN at the provincial and national level. Her dedication
and advocacy made the LPN a vital member of the health care team.
Eligibility Criteria:
Nominees must hold an Active Practice Permit with the CLPNA, be in good standing with the CLPNA,
and consistently demonstrates excellence in leadership through the following attributes:
leads by example, demonstrating professionalism, respect, integrity and collegiality
demonstrates commitment to personal and professional development
advocates for nurses and nursing in the health-care setting
demonstrates a positive attitude
communicates effectively
identifies and effectively promotes needed change
provides mentorship to colleagues
demonstrates passion for the work they do
Nomination Process:
Nominations are accepted from employers or colleagues. The following must be submitted:
Section 1: LPN & Nominator/Sponsor Information
Section 2: A written statement describing specific examples related to the Eligibility Criteria
Nominations will be reviewed by the Selections Committee of the Fredrickson-McGregor Education
Foundation for LPNs. The Award recipient will be announced at the CLPNA’s 2009 Spring Conference.
The Nominator/Sponsors of the Award recipient may be notified in advance in order to ensure the Award
recipient attends the Ceremony. Only complete applications will be forwarded to the Selections
Committee for review. For questions, please contact Foundation Secretary Sherri McLellan at (780)
484-8886 ext.243 or sherri@clpna.com.
Submission Deadline: February 15, 2009
By mail: Fredrickson-McGregor Education Foundation for LPNs
St. Albert Trail Place
13163 146 St
Edmonton, AB T5L 4S8
By Fax: (780) 484-9069
By Email: sherri@clpna.com
Fredrickson-McGregor Education Foundation for LPNs Revised: December 24, 2008
Nomination Form Pat Fredrickson Excellence in Leadership Award Page 1 of 4

Fredrickson-McGregor Education Foundation for LPNs
Pat Fredrickson Excellence in Leadership Award
NOMINATION FORM
SECTION 1: LPN and Nominator/Sponsor Information
We have reviewed the criteria for the Pat Fredrickson Excellence in Leadership Award, and nominate:
LPN’s Name: Registration #
LPN’S PLACE OF EMPLOYMENT
Facility
Address
City
Postal Code
Phone ( ) Fax ( )
NOMINATED BY
Name
Position
Address
City
Postal Code
Phone ( ) Fax ( )
Email
Signature
SPONSORS: Sponsors must be in addition to the Nominator.
Sponsors must be over 18 years and not related to the Applicant.
If possible, one Sponsor should be an Employer, past or present.
Sponsor #1:
Name
Position
Address
City
Postal Code
Phone ( ) Fax ( )
Email
Signature
Sponsor #2
Name
Position
Address
City
Postal Code
Phone ( ) Fax ( )
Email
Signature
Fredrickson-McGregor Education Foundation for LPNs Revised: December 24, 2008
Nomination Form Pat Fredrickson Excellence in Leadership Award Page 2 of 4

SECTION 2
The following information will be used to determine the Award winner. Excerpts may be used at the
Award Presentation Ceremony, and in Foundation and CLPNA publications.
PLEASE ATTACH A TYPED STATEMENT (or print below) describing the reasons why the
nominated LPN deserves this Award. Provide examples from their work using the following
Nomination Criteria. Be specific.
leads by example, demonstrating professionalism, respect, integrity and collegiality
demonstrates commitment to personal and professional development
advocates for nurses and nursing in the health-care setting
demonstrates a positive attitude
communicates effectively
identifies and effectively promotes needed change
provides mentorship to colleagues
demonstrates passion for the work they do
Use the following lines to complete Section 2, or submit a typed statement:
Fredrickson-McGregor Education Foundation for LPNs Revised: December 24, 2008
Nomination Form Pat Fredrickson Excellence in Leadership Award Page 3 of 4

Fredrickson-McGregor Education Foundation for LPNs Revised: December 24, 2008
Nomination Form Pat Fredrickson Excellence in Leadership Award Page 4 of 4