EMPLOYEE OF THE MONTH
INFORMATION SHEET
Nominee’s Name:________________________ Employment ________
Department Name:_____________________ Job Title:_________
Supervisor’s Name:______________________________________
The Employee of the Month Selection Committee wants to identify nominees for this honor. Your opinion will be invaluable in helping the committee to make a selection for the Employee of the Month.
Please rate the nominee on each of the core values .
Never
Demonstrates
Sometimes
Demonstrates
Demonstrates
Most of Time
Always
Demonstrates
1 2 3 4
Sense of Urgency: Rating_______
Responds in a timely manner to exceed customer expectations_________________
___________________________________________________________________
___________________________________________________________________
Teamwork: Rating_________
Works in a cooperative and collaborative manner to achieve our goals___________
___________________________________________________________________
___________________________________________________________________
Accountability: Rating________
Accepts the responsibility and outcomes for decisions and actions_______________
___________________________________________________________________
___________________________________________________________________
Innovation: Rating_______
Creates and uses knowledge in new and different ways to continuously improve services____________________________________________________________
___________________________________________________________________
___________________________________________________________________
Respect: Rating________
Values the uniqueness and work of each individual and treats everyone with dignity
___________________________________________________________________
___________________________________________________________________
Signatures:________________________________________________________
Please return
Sharon Williams, Customer Service/Marketing, H102 Hospital 0293,
Phone: 257-2178, email: sawilld@email.uky.edu