Thomas Green Awards Nomination Form

Form
2025 Thomas S. Green Public Service Award Nomination Form

Please return no later than Friday, March 14, 2025
Nominee*

First NameLast Name
City/Town of Employment*
Role*

DepartmentPosition
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nominator*

First NameLast Name
Affiliation to Nominee*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nomination Process: Please submit an introductory letter that reviews some or all of the criteria below. One additional letter of support is required; multiple letters, especially those from multiple perspectives (supervisors, subordinates, population served, etc.) are highly encouraged. Other creative submissions, such as videos, multi-media presentations, etc., are accepted.

Criteria: The Committee would like insight into the capacity and character of the nominees. Below, we offer various criteria for consideration and questions to consider while completing your nomination. We do not expect that nominators will be able to evaluate nominees on all criteria or answer all of these questions. Please describe why your proposed nominee is deserving of this recognition and their qualities in those areas that you feel most competent. Feel free to coordinate on this review with others who may be able to provide additional insight into the nominee.
Job Performance/Competence
Does the nominee excel at his/her position and is he or she fully competent at assigned responsibilities?
Efficiency
Is the nominee efficient with time, resources,and effort to complete responsibilities?
Responsiveness
Is the nominee responsive to public requests forassistance, including phone calls and emails?
Professionalism
Does the nominee exhibit professionalism withthe public and fellow employees?
Initiative
Is the nominee self-motivated, taking initiativewhen dealing with issues and/or opportunities?
Innovation
Is the nominee innovative, able to identify new,better means for accomplishing responsibilities?
Adaptability
Is the nominee open to change and able toembrace new policies, responsibilities, situations, and leadership?
Dedication
Does the nominee go beyond the normal jobrequirements to assist the public or colleagues with extraordinary tasks?
Collaboration
Is the nominee a team player, able to respectand value differences, and embraces diversity, equity, and inclusion?
Enthusiasm
Does the nominee exhibit enthusiasm for his/herjob and responsibilities?
Involvement
Is the nominee involved in the community throughvolunteer opportunities, participation in local events, or support for localcauses?
Letters of Support:

Ona separate sheet, please describe the nominee’s role and explain specificallyhow he or she has performed those job responsibilities in an exceptionalmanner. One additional letter of support from supervisors, peers, and membersof the public and/or documentation of outstanding work is required. Multiple lettersare highly encouraged.
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Form

2025 Thomas S. Green Public Service Award Nomination Form