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Please read the winner's agreement before applying

First name

Surname

Email

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Birthday

Where to you work or study?

How long have you worked or studied?

If you are currently studying within a UW School of Nursing program, when do you expect to graduate? (please stipulate year)

Please stipulate which UW SON campus you are studying for your BSN or ABSN?

If you are an alumni of the UW School of nursing, please stipulate when you graduated (write in year and type of nursing degree your graduated with)

What type of setting do you currently practice in? (select all that apply)

Hospital

Skilled Nursing Facility

Assisted Living Facility

Adult Family Homes

Primary Care

Home Health

Hospice

Outpatient Specialty Care

Memory Care Unit

I'm a nursing student

Other

If "Other", please provide more information here.

Gender (select all that apply)

Male

Female

Nonbinary

Other

Prefer not to answer

Preferred pronouns

Race / Ethnicity (select all that apply)

African American

American Indian/Alaska Native

Asian

Caucasian/White

Hawaiian/Pacific Islander

Hispanic/Latinx

Other

Prefer not to answer

Category

I am a licensed, practicing registered nurse (RN) who graduated from any of the three University of Washington nursing programs (UW Seattle, UW Bothell, or UW Tacoma)

I am a practicing registered nurse

I am a nursing student

How did you learn about the Queen Silvia Nursing Award?

From a friend

From a colleague

From my employer

From my school

From Instagram

From Facebook

From LinkedIn

From news articles

From TV

From YouTube

From TikTok

Podcast

Other

Select an option

I am submitting an idea that is not yet implemented.

I am submitting an idea that is currently in the process of being applied or used.

Please describe your idea. (100 words)

Identify the problem or challenge that the idea addresses. (100 words)

Present the benefits of this idea for improved quality of care for older adults or people living with dementia. (100 words)

Please describe how your idea is innovative, original, or unique. (100 words)

Please describe your implementation plan for your idea. (100 words)

Please share your ideas for identifying and obtaining any necessary funding or partnerships to grow or sustain this project. (100 words)

Please attach a photograph of yourself in png or jpg format with a file size that is maximum 10 MB in size. This will only be used if you are announced as a finalist.

Upload File

Upload supported file (Max 15MB)

You are welcome to submit a maximum 90-second video that gives you an opportunity to explain your idea.

Upload File

Upload supported file (Max 15MB)

I consent to the collection, storage, and processing of my personal data as described in the Privacy Policy.

Thanks for applying! A confirmation has now been sent to your email address.

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