Golden West College
Charlie Sianez Exceptional Service Award
2015-2016
Nomination Form
Eligibility
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Nominees must be current, permanent or part-time faculty members, managers, or
classified staff members.
Current award recipients and nominees for Classified Employees of the Month, Teacher
of the Year, and Manager of the Year are eligible.
If a task force member is nominated, s/he will be replaced on the task force.
No one may receive this award more than once in a five year period.
Please be descriptive as possible, as this is the only mechanism by which nominations are rated.
Name of Nominee:
1. Describe how the nominee has made an outstanding service contribution to the campus that
is outside his/her normal job description.
2. Describe how the nominee has made an outstanding service contribution to the community.
3. Describe how the nominee demonstrates outstanding character traits such as integrity,
dependability and respect for the rights and beliefs of others.
Submitted by:
Date:
Deadline for submission to task force chair, Jeff Courchaine: April 29, 2016