IWIN Application

International Women in Nursing Application

Date

Your Name

Gender

Preferred Address Type (home or work)

Preferred Email

Preferred Phone Number

Education

Credentials

Employment Status

Full-time Part-time Retired Not currently employed

Current Employer

Work Address

Current Position/ Title

Speciality

Nursing License Number

Are you a Sigma Member? (Sigma membership is not required and will not influence academy acceptance.)

Yes No

Do you have a mentor for the academy?

Yes No

Academy Acknowledgements

I have institutional endorsement to attend and fulfill academy requirements. I have access to technological equipment (Zoom, internet, etc.) necessary to fulfill academy requirements.

What influenced you to join International Women in Nursing?

Example of achievement in nursing as defined by Sigma Theta Tau

Do you have an idea for your academy project?

Please provide a short essay addressing your needs and expectations for your development during the academy.

Upload: resume or CV, proof of current licensure, copy of degrees, short essay addressing your needs and expectations, institutional endorsement letter from your employer.

Sample endorsement letter: institendorsementltr-sample.pdf (sigmanursing.org)

Read how Dr. Love has inspired early careerists in healthcare to achieve professional success.

Read how Dr. Love has inspired healthcare professionals seeking to advance their careers.

“Meeting Dr. Love in person was all that I expected it to be and more! She and I had been Twitter friends and had a chance to meet at a virtual conference in 2020. I value Dr. Love’s words of wisdom so much so that I asked her to be my mentor at the same conference in 2021. We’ve been meeting consistently, and I have implemented her recommendations as I know she will hold me accountable. Dr. Love’s support over the short time that we have been acquainted, outside of Twitter, has already made a significant impact on my life.”

Sheritta Strong, MD

Assistant Vice-Chancellor of Inclusion, University of Nebraska Medical Center

We are committed to advancing diversity, equity and inclusion (DEI) at all levels within the healthcare industry, regardless of gender, race, ethnicity, religion, age, sexual orientation, disability, veteran’s status, economic status or other diverse backgrounds.

Contact Dr. Tiffany Love at

Email: tlove@loveleadershipfoundation.org
Phone: 1-802-398-7051

Address: 105 Court street PMB 263 Middlebury VT, 05753.

International Women in Nursing Application

Read how Dr. Love has inspired early careerists in healthcare to achieve professional success.

Read how Dr. Love has inspired healthcare professionals seeking to advance their careers.

We are committed to advancing diversity, equity and inclusion (DEI) at all levels within the healthcare industry, regardless of gender, race, ethnicity, religion, age, sexual orientation, disability, veteran’s status, economic status or other diverse backgrounds.

Love Leadership Foundation 501(c)(3) nonprofit organization for educational purchases.

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