Quarter*

Year*

Nominee Information

Name of Nominee*

Department*

Title/Position*

Nominees will be evaluated entirely on the basis of the information submitted on the nomination form. Co-workers are encouraged to work together to submit a nomination form.

Please provide a statement describing specific examples of excellence in the criteria sections listed below which are applicable to your nominee. The nomination will be scored based on the rubric for each criteria section.

Your comments may be shared with the nominee and members of the college community.

Exemplary Work Performance

Criteria: Excellence in work performance Goes above and beyond the call of duty Is creative and efficient in accomplishing tasks

Hidden

Exemplary Work Performance Score

3 points - Clear examples or evidence is given for all of the stated criteria.
2 points - Examples or evidence is given for some of the stated criteria, but not all.
1 point - Incomplete response.
0 points - No examples or evidence is given for the stated criteria.

Hidden

Outstanding Customer Service to the College

Criteria: Consistent high-level of service to the students, the public, the community, co-workers, etc.

Hidden

Outstanding Customer Service Score

3 points - Clear examples or evidence is given for all of the stated criteria.
2 points - Examples or evidence is given for some of the stated criteria, but not all.
1 point - Incomplete response.
0 points - No examples or evidence is given for the stated criteria.

Demonstrates Initiative and Cooperative Spirit in Maintaining a Positive College Environment

Criteria: A high level of individual and team cooperation in job performance Participation in college activities and events Strong communication skills Positive interaction among faculty, staff, students and the public Exhibits respect for fellow workers and students.

Hidden

Demonstrates Initiative and Cooperative Spirit Score

3 points - Clear examples or evidence is given for all of the stated criteria.
2 points - Examples or evidence is given for some of the stated criteria, but not all.
1 point - Incomplete response.
0 points - No examples or evidence is given for the stated criteria.

Special Achievements or Contributions to the College Community

Criteria: Initiates or gets involved in special projects for the betterment of a department or the college community Initiates efficiency measures and improved ways of serving students or staff Serves in leadership roles with campus groups/committees

Hidden

Special Achievements/Contributions Score

3 points - Clear examples or evidence is given for all of the stated criteria.
2 points - Examples or evidence is given for some of the stated criteria, but not all.
1 point - Incomplete response.
0 points - No examples or evidence is given for the stated criteria.

Fosters and Supports Individual and Organizational Diversity and Inclusion

Criteria: The nominee shows a visible commitment to diversity in written correspondence and oral communication; actively engages in campus diversity strategies; supports recruitment, retention and completion efforts of students from diverse backgrounds; participates in equitable hiring practices for their departments or college-wide recruitments; creates a culture of accountability.

Hidden

Total Points

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