Employee Recognition Nomination Form

Company Letterhead

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{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

Form Title

Employee Recognition Nomination Form

Date of Nomination

Date: {{date}}

Nominator's Information

Nominator's Name: {{nominator_name}}

Department: {{nominator_department}}

Job Title: {{nominator_job_title}}

Contact Email: {{nominator_email}}

Nominee's Information

Nominee's Name: {{nominee_name}}

Department: {{nominee_department}}

Job Title: {{nominee_job_title}}

Recognition Category (Select one or more)

Please tick the appropriate category(ies) for this nomination:

[ ] Outstanding Performance

[ ] Innovation and Creativity

[ ] Teamwork and Collaboration

[ ] Customer Service Excellence

[ ] Leadership and Mentorship

[ ] Community Involvement

[ ] Other (Please specify): {{other_category_specify}}

Reason for Nomination

Please describe in detail why you are nominating this employee. Provide specific examples of their contributions, achievements, and how their actions align with the recognition category(ies) selected above. (Min. 100 words):

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Impact of Nominee's Contributions

Explain the positive impact of the nominee's contributions on the company, team, or customers. Quantify impact where possible (e.g., increased revenue, improved efficiency, enhanced morale):

{{impact_of_contributions}}

Additional Supporting Information

Include any additional information, testimonials, or supporting documents that strengthen this nomination (e.g., project outcomes, peer feedback, client accolades). Attach separate documents if necessary and reference them here:

{{additional_supporting_information}}

Nominator's Declaration

I hereby confirm that the information provided in this nomination form is accurate and true to the best of my knowledge.

{{nominator_name}}

Signature Block

_____________________________

Signature of Nominator

Date: {{signature_date}}

For Official Use Only

Received By: _____________________________

Date Received: {{official_receipt_date}}

Committee Decision: {{committee_decision}}

Award Granted: {{award_granted}}