Dr. Ben Ranck Employee Excellence Award Nomination Form
Guidelines:
Nominee must be a part or full time team member of Our Hospice of South Central Indiana or Palliative Care for one calendar year or longer.
Nominations need to be returned to your supervisor by the 15 of the second month of active award quarter (February 15, May 15, August 15, November 15)
Team members may be nominated more than one time in twelve months, but each team member is only eligible to win once per calendar year.
Date
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Month
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Year
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Nominee’s Name
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Nominee's Location
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Nominee's Position
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Your Name
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Please explain why this nominee should be considered for the Ranck Award. (Please provide clear and specific examples)
How does the candidate go “above” current job duties?
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Give clear and specific examples of demonstrating Standards of Service.
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(See policy, if needed)
Do Not Proceed: This section is to be completed by supervisor of nominee
Why should this team member be nominated for the Ranck Award?
Why is this team member a good role model and/or team player?
How does this team member practice good communication skills and behavior with all departments of the organization?
Supervisor Name
Date
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