nomination form: LEADERSHIP
Description
The purpose of the LEADERSHIP award is to recognize and reward employees who
demonstrate exemplary leadership capabilities and consistently achieve superior, teambased results. These leaders play an exceptional role in helping others contribute to their
organization and advance its mission.
Traits of Ideal Candidates
 Empower others and delegate responsibility
 Demonstrate strong relationship building abilities
 Foster cross organizational teamwork
 Promote and celebrate diversity
 Have exceptional communications and listening skills
 Introduce and manage change effectively
 Inspire those around them
How to Submit
 Nomination forms must be submitted by email (awards@unitedwaypeel.org) no later
than Friday, May 22, 2015 at 5 p.m.
 Remember: Winners are determined solely on this nomination form. Please be as
specific as possible when describing projects/accomplishments
How the Award Works
 Employees may nominate their peers but downward nominations are not accepted
 No self-nomination or nomination of family members
 All information will be verified by the nominee’s supervisor
 Achievements must occur during the time period from January 2014 to December 2014
Nominee Information
First and Last name:
Title:
Program, project, department or initiative:
E-mail:
Phone:
Agency Name
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First Nominator
Second Nominator (Optional)
First and Last name:
First and Last name:
E-mail:
E-mail:
Phone:
Phone:
Nominee’s Supervisor
First and Last name:
E-mail:
Phone:
Please select the THREE qualities that best describe the accomplishments of the
nominee.
Empower others and delegate responsibility
Demonstrate strong relationship building abilities
Foster cross organizational teamwork
Promote and celebrate diversity
Have exceptional communications and listening skills
Introduce and manage change effectively
Inspire those around them
Provide a specific example for each of the three qualities selected that clearly illustrates
why it applies. (150 words maximum)
Please share a story and/or project that clearly demonstrate the individual’s exceptional
leadership, as well as the positive impact or outcome for the community. (250 words
maximum)
Thank you!
An email will be sent to the primary nominator to confirm that the submission form was received.
All nominations will be reviewed by a selection panel. Award winners will be announced and
recognized during our Annual General Meeting on June 23, 2015.
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