Fillable PSA Award Nomination Form

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PSA Award Nomination Form

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Human Resources
2013-14
Presidential Staff
Achievement Award
NOMINATION FORM – due by Friday, Jan. 24, 2014
NOMINEE:
Name ______________________________________ Title __________________________________________
Department _________________________________ Division _______________________________________
Length of service at UD _______________________ Length of service in current role __________________
Supervisor and title _____________________________________________________________________________
Phone number ______________________________ Campus ZIP code ______________________________
NOMINATOR:
Name ______________________________________ Title or role ___________________________________
Department _________________________________ Phone number _________________________________
(if applicable)
NOMINATION RATIONALE: Please describe the nominee’s specic contribution in light of each
of the three questions below. Word count for all the questions (combined) should not exceed 500 words.
For more information, visit go.udayton.edu/staffaward
.
1) How did the nominee demonstrate one of the competencies found in the strategic/results dimension
included in the Critical Leadership Competencies of a Catholic and Marianist University? Cite the
competency (behaviors listed under the dimensions), and be specic about the actions and the
outcomes of a recent, exceptional accomplishment — or provide details about your nominee’s
excellent performance over time.
2) How did the nominee demonstrate one of the competencies found in the personal character or
people/interpersonal dimensions included in the Critical Leadership Competencies of a Catholic and
Marianist University? Cite the competency and be specic about the actions and the outcomes of a
recent, exceptional accomplishment — or provide details about your nominee’s excellent performance
over time.
3) How did the nominee’s actions go above and beyond the expectation of his/her job responsibilities?
Please be specic about why the nominee is being put forth for this award in this current award year.
Please enter your letter of nomination on page 2.
OTHER ENDORSEMENTS: Please identify up to ve additional community members whom you have
asked to write letters of support for this nominee, addressing the same questions above. Nomination forms
and letters of support should be emailed to staffaward@udayton.edu or mailed to the Presidential Staff
Achievement Award committee, +1614.
SUPPORTERS: Faculty Staff Student
1. _____________________________________________________________
2. _____________________________________________________________
3. _____________________________________________________________
4. _____________________________________________________________
5. _____________________________________________________________
Human Resources
2013-14
Presidential Staff
Achievement Award
LETTER OF NOMINATION:
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PSA Award Nomination Form

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Completed 2 March 2020

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