Impact Fellow of the Month - June

Nominator

Details of the person submitting the nomination.

Name *

First

Last

Nominee Information

Details about the team member being nominated.

Name *

Why are you nominating this team member? *

Please rate your nominee on the following *

	Low	Moderately Low	Average	Moderately High	Highly
Commitment to Excellence	Commitment to Excellence Low	Commitment to Excellence Moderately Low	Commitment to Excellence Average	Commitment to Excellence Moderately High	Commitment to Excellence Highly
Respect for others	Respect for others Low	Respect for others Moderately Low	Respect for others Average	Respect for others Moderately High	Respect for others Highly
Dedication to service	Dedication to service Low	Dedication to service Moderately Low	Dedication to service Average	Dedication to service Moderately High	Dedication to service Highly
Degree of reliability	Degree of reliability Low	Degree of reliability Moderately Low	Degree of reliability Average	Degree of reliability Moderately High	Degree of reliability Highly
Professional Courtesy	Professional Courtesy Low	Professional Courtesy Moderately Low	Professional Courtesy Average	Professional Courtesy Moderately High	Professional Courtesy Highly
Belief in Workplace Equality	Belief in Workplace Equality Low	Belief in Workplace Equality Moderately Low	Belief in Workplace Equality Average	Belief in Workplace Equality Moderately High	Belief in Workplace Equality Highly
Degree of Dependability	Degree of Dependability Low	Degree of Dependability Moderately Low	Degree of Dependability Average	Degree of Dependability Moderately High	Degree of Dependability Highly
Commitment to others growth	Commitment to others growth Low	Commitment to others growth Moderately Low	Commitment to others growth Average	Commitment to others growth Moderately High	Commitment to others growth Highly
Personal Performance	Personal Performance Low	Personal Performance Moderately Low	Personal Performance Average	Personal Performance Moderately High	Personal Performance Highly
Departmental Performance	Departmental Performance Low	Departmental Performance Moderately Low	Departmental Performance Average	Departmental Performance Moderately High	Departmental Performance Highly

How does your nominee's actions impact on your own work? *

What are your nominee's greatest strengths? *

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