Employee Recognition Nomination Form

Enter name and division then click “Add”. You can add as many people as you want, as long as they are all for the same award. If you wish to nominate someone for a different award, you will need to fill out a separate form.

I wish to nominate:
For the following award (choose one)
Team Award - To recognize a group of people with a full set of complementary skills used to complete a task, job, or project. PRIDE Care Values Award - For consistently demonstrating FMD’s core values of (PRIDE) Professionalism, Respect, Integrity, Dedication and Excellence.
Innovation Award - To recognize and honor persons who develop a new idea or practice which improves and streamlines department processes, services, technologies, etc. resulting in increased productivity, better customer service, etc. Excellence In Leadership Award – For consistently serving as a role model who inspires others to be innovative and to achieve common goals while building and improving the knowledge and capabilities of the workforce. This award requires perfect attendance within the fiscal year quarter of the nomination.
Community Service Award - To recognize and honor persons who are making significant contributions to their community through their time, actions, talents and dedication within or outside of WUSM. Kudos Award - For positive feedback, praise received and acknowledgement of customer service
Be the Change Award - To recognize someone whose actions create positive strategic changes, and serves as a model by offering inspiration and support to others.
Please comment on why this employee is an excellent candidate to receive this award. Be as specific as possible and provide examples. If nomination is a result of a customer accolade, please attach customer’s memo or email and no further explanation will be needed.






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