New Mexico Public Service Awards Council
2015 NOMINATION FORM
Warning: You must complete this form within 24 minutes or it could expire and the data you have entered could be lost.
ELIGIBILITY: Nominees must be residents of, or employed in, New Mexico.
CRITERIA: Either as public employees or as private citizens, nominees must have made significant contributions to the public service. Nominations must be concise and clear; if additional space is required, use no more than two additional sheets.
DEADLINE FOR FILING: MUST BE RECEIVED BY THURSDAY, SEPTEMBER 10TH, 2015
Mail or deliver to:
  Mr. Sherman McCorkle
Sandia S&T
Development Corporation
1451 Innovation Parkway SE, Suite 600
Albuquerque, NM 87123
 
1. BASIC INFORMATION ON NOMINEE (Use NA where not applicable)
Nominee's Name: Postion: Nominee's Phone:
Employed By: Address of Employer: Employer's Phone:
Supervisor's Name & Title: Supervisor's Phone: Nominee's Home Address:
EmailID:        
Category of Award (Check One) Fed or Labs State or University Local or Native American Business or Civic
 
2. PUBLIC EMPLOYEE JOB PERFORMANCE
For private citizens omit item 2 and provide full details in item 3.
(A) QUALITY OF PERFORMANCE:
    List performance awards and citie statement by employer that reflect exceptional performance. Citie specific ways in which the nominee has improved the public service , or encouraged other public employees or to pursue excellence.
   
  (B) CONTRIBUTION TO JOB:
    List improvements, innovations, ideas or actions that have contributed to greater effectiveness, reduced cost, or wider acceptance of governmental operations.
   
 
3. OFF THE JOB CONTRIBUTIONS
  SERVICE TO THE COMMUNITY
 
  For public employees, describe participation in community service, professional and service organizations.
  For private citizens, describe participation in community activities on a voluntary basis which specifically improve the public service.
 
 
 
4. (OPTIONAL) NO MORE THAN THREE LETTERS FROM PERSONS ATTESTING TO THE ACCURACY OF THE ACCOMPLISHMENTS OF THE NOMINEE MAY BE INCLUDED.
   
   
 
 
5. PERSON MAKING NOMINATION
Name: Business Phone: Home Phone:
Business Address: Relationship to Nominee (Work Associate, Co-worker, ETC.): Date:
Email Address: