Nomination for
OUTSTANDING PERFORMANCE AWARD
Employee's Name ________________________________________________ Initial Hire Date _________ Dept Hire Date _________
Service Area ______________________________________________ Department _______________________________________
Nominating Supervisor's Name ________________________________________ Title _____________________________________
Please explain your nomination in terms of one or more of the following five criteria. Use additional pages as necessary. Please be
very specific in describing the employee's performance and contribution.
1. CONSISTENT OVERALL EXCELLENCE OF PERFORMANCE: This employee has demonstrated exceptional performance on a
significant number of factors and has received at least an exemplary overall rating.
2. ATTENDANCE, RELIABILITY AND DEDICATION: This employee always arrives to work station on time (or early), has rendered
levels of service beyond the norm over an extended period of time, shows dedication to the tasks of the job and is willing to put in
additional hours beyond the normal work schedule if necessary.
3. SPECIAL CONTRIBUTIONS: This employee has had an impact on the department and/or the company. He/she has successfully
completed a major or difficult project, or has shown exceptional initiative by offering or helping to carry through ideas or concepts that
have resulted in significant service, operational or financial improvement(s).
4. EXCEPTIONAL LEADERSHIP: This employee has provided leadership beyond that which is normally required of his/her position by
taking on additional responsibilities, providing training for other full-time and/or student employees or by providing leadership aiding in
the attainment of major goals and objectives.
5. OTHER FACTORS: Are there other factors regarding this employee's performance that you feel merit consideration for a bonus
award. Please explain.
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Nomination for
OUTSTANDING PERFORMANCE AWARD
Summary for Executive Director Publication: Please, include a summary, not to exceed 150 words, describing why the employee
received the nomination. This section will be used in a newsletter that the Executive Director emails out to all of the AS staff,
congratulating the recipients.
Eligibility Requirements for Nomination for Outstanding Performance Award
1. Both part- and full-time employees are eligible for this award.
2. Employee must have satisfactorily completed their six month probationary period and have received an exemplary overall rating on
his/her most recent performance evaluation.
3. The most recent performance evaluation must have been given by the nominating department.
NOTE: Preference will be shown to employees who have more than one year of continuous service.
Recommended by:
Supervisor __________________________________________________________ Date _______________
Comments: ______________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Department Manager __________________________________________________ Date _______________
Comments: ______________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Approved by:
Area Director ________________________________________________________ Date _______________
Comments: ______________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Executive Director ____________________________________________________ Date _______________
Comments: ______________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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