APPLICATION FOR MEMBERSHIP: NURSE LEADER

The purposes of Sigma Theta Tau are to:

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 of
nursing.

Those qualified to apply are:

1. Legally recognized to practice nursing in his/her country
2. Minimum of a baccalaureate degree or the equivalent in any field
3. Demonstrated achievement in nursing. Examples:
Creativity/Innovation in clinical practice
Leadership qualities contributing to improved health care
Teaching
Administration
Curriculum development
Improvement of the status of nursing organizations
Innovative student-focused learning approaches
Research development utilization
Entrepreneurial skills
Staff development
Mentoring of colleagues
Innovative professional recognition of programs

The procedures for application are:

1. Electronic application. Type the application in Word and save with the
following format (nurse_leader_year_last name_first name)
2. Submit current Curriculum Vitae (CV) in word .doc or .pdf format.
3. Two references and one membership endorsement (form available on
AE website). Endorsement form should be saved in word .doc or .pdf
format and emailed to applicant. The endorsement reference must be
a current Alpha Eta Chapter member. Choose your endorsement
person carefully, as he/she should be able to respond in detail to the
majority of areas listed on your application form
4. Submit the application and all required documents in one submission
via email to alpha.eta@nursing.ucsf.edu Subject: Nurse leader
application
5. Please check the chapter website (www.alphaeta-ucsf.org) for
application due dates.

The Eligibility Committee will review your application, and will notify you of
the Chapter's decision regarding your membership. A fee of $135.00 is due.
(This includes annual fees of $114.50 [$69.50 for the national organization,
and $45.00 for the local chapter] and a one-time Induction fee of $25.00).
Revised 1/30/2015
 APPLICATION FOR MEMBERSHIP: NURSE LEADER
All fees will be due before the induction ceremony in the Spring (date TBA).
All inductees are expected to attend the ceremony. Family and friends are
welcome!
MEMBERSHIP INTENT FORM

Name (Last, First Middle):

Address:

City, State, Zip:

Telephone (Home): Telephone (Work):

Email (required to process application):

Education (List year of graduation and Institution)

B.S.:

Education (List year of graduation and Institution)

M.S.:

Education (List year of graduation and Institution)

Ph.D.:

Please attach a CV that details your Professional Work, Community

Participation, Professional Activity, and other recent Contributions
to Nursing.

Professional Goals:

Goals for joining Sigma Theta Tau:

Reference Name: Reference Position/Address:

Reference Name: Reference Position/Address:

Submit the application and all required documents in one submission via
email to alpha.eta@nursing.ucsf.edu Subject: Nurse leader application