Children's Specialized Hospital

Shining Star Program

Who would you like to nominate? (*indicates a required field)

*Nominee's First Name:

*Nominee's Last Name:

*Nominee's Department:

*Site:

*Values:

Compassion Team Work Excellence
Fun Innovation Integrity

Reason for Nomination:

And who are you?

Your Name:

*I am:

Phone Extension:

*Email Address:

*Confirm Email Address:

1-888-CHILDREN
1-888-244-5373