Spirit of Excellence Award - Nomination Information


Directions

  • Copy/paste the text below into an email or a text file. Alternately, if you would like a Word copy of the form, please contact Joel Friedman at 703-324-4433 (TTY 711).
  • Answer both questions clearly and concisely. What you submit is the only information by which the nomination will be rated.
  • Adhere to maximum word limits for both questions.
  • Nominee and nominator names will be removed prior to rating.
  • Nomination forms should be received or postmarked no later than January 31, 2017 and may be returned to any CSB office or service site or sent directly to Joel Friedman by mail (12011 Government Center Parkway, Suite 300, Fairfax, VA 22035), fax (703-324-4490), or email.
  • If you have questions, please contact Joel Friedman at 703-324-4433 (TTY 711).

Nomination Form Information

Date

Nominator Information

  • Name
  • Position title (if CSB employee)
  • Program/service area (if CSB employee)
  • Telephone
  • Email address

Nominee Information (If this is a team nomination, list additional team members [to include name, position title, and program/service area]. Also identify those team members who are not CSB employees.)

  • Name
  • Position title
  • Program/service area
  • Is the nominee a CSB employee?

Select the one area for which the nominee(s) is/are nominated:

  • Leadership
  • Customer Service
  • Innovation
  • Stewardship
  • Good Samaritanship

Questions (Please be concise. This is the only information by which the nomination will be rated. Adhere to maximum word limits.)

  1. Describe how the nominee promoted, reinforced, or exemplified the CSB vision, mission and values in the areas nominated. (Maximum 500 words.)
  2. Describe how the nominee’s promotion, reinforcement, or exemplification of the CSB vision, mission and values went above and beyond his/her routine job duties and responsibilities. (Maximum 500 words.)

Signature of Nominator

 

Learn about the criteria for the Spirit of Excellence award.


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Tisha Deeghan, Executive Director

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