DISTINGUISHED SERVICE AWARD
NOMINATION FORM
APAS _____
Exempt Professional/Administrative Staff _____
Exempt Classified Staff _____
Full Time or Part Time _____
Each year the University recognizes the contributions of members of the Classified Exempt and Professional/Administrative
staff with the
conferral of Distinguished Service Awards. (Please note that the President, Vice Presidents, Deans, Executive
Directors and Faculty are
not eligible for consideration.)
Nominations may be submitted by YSU faculty, staff, students,
or alumni.
Professional/Administrative staff awards are based upon "outstanding performance of duties." Classified Exempt staff
awards are
based upon “outstanding performance of their duties and/or public/community service.”
Submit nominations to Linda Moore in the Office of Human Resources in Tod Hall Room 312
by
5:00 P.M. JANUARY 31
(or the Friday before if this lands on a weekend).
The following individual is nominated for the Distinguished Service Award:
NAME: ____________________________________________________________________________________________________
TITLE: ____________________________________________________________________________________________________
DEPARTMENT: _______________________________________________________________________________________________
DATE OF APPOINTMENT AT YSU (if known): ____________________________________________________________________
JUSTIFICATION FOR NOMINATION
If additional space is needed, so state and
add UP TO ONE SINGLE-SIDED page.
NAME OF NOMINATOR: _________________________________________________________________ PHONE: ______________________
(Please Print)
YSU AFFILIATION (Check all that apply): FACULTY STAFF STUDENT ALUMNUS
CAMPUS DEPT/ MAILING ADDRESS: ______________________________________________________________________________________
(Please Print)
SIGNATURE: Date:
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