The Purposes of Sigma Theta Tau International are: Recognize superior achievement. Recognize the development of leadership qualities. Foster high professional standards. Encourage creative work. Strengthen commitment to the ideals and purposes of the profession.

CRITERIA:  Nurses with a minimum of a baccalaureate degree who have demonstrated  
marked achievement in education, practice, research, administration or publication.  

Name:_______________________________________________________________  
            (Last)                              (First)                                       (Middle initial)  

Address:_____________________________________________________________  

Phone Number: _______________________________________________________  

Formal Education:  (List highest degree first and attach a copy of documentation of highest 
degree received).  
_____________________________________________________________________  
_____________________________________________________________________  
_____________________________________________________________________  
_____________________________________________________________________  

Please check areas of achievement in Nursing: 
______   Education                      ______   Administration  
______   Practice                        ______   Publication  
______   Research                      ______   Other (please indicate) _______________  

Please list your most recent (last five years) contributions to nursing in areas checked above.  
______________________________________________________________________  
______________________________________________________________________  
______________________________________________________________________  
______________________________________________________________________  
______________________________________________________________________  
      

_________________________________________                        __________________  
Candidates Signature                                                                                                               Date  

Please attach to this form two letters of endorsement from active members of Sigma Theta Tau.

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Sigma Theta Tau International
Epsilon Zeta Chapter
Honor Society for Nursing
College of Health and Human Services
George Mason University
4400 University Drive
Fairfax, VA 22030