APPLICATIONS CAN BE SENT BY MAIL OR EMAIL TO:

Kathleen Barbieri

11 Stonehenge Dr

Medford NJ 08055

kbarbieri@lumberton.k12.nj.us

2025-2026 Application

“Burlington County School Nurse of the Year” Application

Name: ___________________________________________________

Address: __________________________________________________

Home Phone/Cell Phone: _____________________________________

Nursing Education: __________________________________________

Current Employment:

District: ___________________________________________________

School Building: _____________________________________________

Work Phone: _______________________________________________

Work E-mail: ________________________________________________

Population cared for: _________________________________________

Work Experience:

How many years employed as a NJDOE-CSN? ______________________

How many years as an active member of BCSNA? ___________________

How many years as an active member of NJSSNA/NASN? (Must be current member).

Professional Affiliations: _______________________________________

Nominated By: _______________________________________________

(May include a brief letter written by the individual who nominated you, if applicable.)

Please list a brief example of your performance related to at least three of the Standards of Professional School Nurse Practice

and at least three of the Standards of Professional Performance in School Nursing.

(National Association of School Nurses and American Nurses Association.)

Standards of School Nursing Practice

Assessment

Diagnosis

Outcomes Identification

Planning

Implementation

Evaluation

Standards of Professional Performance in School Nursing

Ethics

Education

Evidence-based Practice

Quality of Practice

Communication

Leadership

Collaboration

Professional Practice Evaluation

Resource Utilization

Environmental Health

Program Management