DISTINGUISHED SERVICE AWARD
NOMINATION FORM
YSU ACE Bargaining Unit Members ONLY
Full Time (FT) or Part Time (PT) _____
Each year the University recognizes the contributions of members of the Youngstown State University
Association of Classified Employees staff with Distinguished Service Awards.
(Please note that this form is for
YSU ACE bargaining unit members ONLY.)
Nominations may be submitted by YSU faculty, staff, students,
alumni, and/or the community.
:
• Must be in Good Standing in the YSU-ACE Bargaining Unit
• Must exhibit outstanding performance of their job duties and/or public/community service
• Must not have received the award within the last three (3) years
• Must have Satisfactory/Meets Requirements or better overall rating on the last two Performance
Evaluations
• Must not have any disciplinary actions in their personnel file in the last two (2) years
Submit Nominations To:
Linda Moore
Office of Human Resources, Tod Hall Room 312
Nomination Deadline: 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 page.
Please type or print:
NAME OF NOMINATOR: ___________________________________________ PHONE: ______________________
MAILING ADDRESS: _______________________________________________________________________________
YSU AFFILIATION: _____FACULTY _____STAFF _____STUDENT _____ALUMNI _____COMMUNITY
SIGNATURE: DATE:
Human Resources 01.03.2017 ldm
