Form for Employee of the Month

							                                      NOMINATION FORM

             RIVERSTARS EMPLOYEE OF THE MONTH
                                            May 2011

Each month, the Human Resources department recognizes an outstanding employee who
excels in a particular area (the month’s theme) as the Riverstars Employee of the Month.
Winners are chosen by a broadly representative, interdivisional committee which bases its
decisions on specified criteria, which vary from month to month depending on the theme for that
month. Prizes include an automatic nomination for the annual Chancellor’s Excellence Award, a
recognition plaque, and a $125 (taxable income) gift certificate (chosen by the winner from a list
of available certificates).

                       CRITERIA FOR NOMINATION AND SELECTION

The nominees must:
   1. Be non-academic, benefit eligible employees employed with UMSL for at least one year.
   2. Be in a staff position at the level of “Director” or below.
   3. Have no disciplinary actions within the last two years.
   4. Have a “meets” or “exceeds expectations” rating or equivalent on most recent
      performance appraisals. He or she must be an employee in good standing who is
      especially outstanding in the current month’s theme.
   5. Not have won an Employee of the Month or Chancellor’s Excellence Award within the
      past three years.
Supervisors may NOT nominate subordinates and subordinates may NOT nominate supervisors
to prevent the perception of favoritism. Self-nominations are not accepted. Your nomination
information is kept confidential. If your nominee is selected, information you provided may be
used without attribution. All materials related to specific nominations will be destroyed within 30
days after the recognition program.

                           HOW TO NOMINATE A STAFF MEMBER

   1. Complete the nomination form. After you download or print the form, describe how the
      candidate meets each criterion by checking each box and writing a short description
      using specific examples. If you have additional comments, you can expand the amount
      of space under each criterion, as needed. You may attach an additional sheet of paper if
      necessary, but please keep these comments to 100 words or less.
   2. If you need assistance, call Human Resources, 516-5805.
   3. Return your completed nomination form by campus mail to: Human Resources, 211 GSB
      or by e-mail to drapern@umsl.edu.

Deadline for nomination: May 17, 2011 at 4:30 p.m.
              UMSL RIVERSTARS EMPLOYEE OF THE MONTH NOMINATION FORM
                                              MAY 2011
                            THIS MONTH’S THEME – “INNOVATION & CREATIVITY”

These nominees are always looking for ways to do things differently in a way that will create value for the customer
or student, whether internal or external. They are energetic and always ready to take on a new challenge. The
environment around them thrives on change, flexibility, and adaptability. They work to make the impossible
possible.
                                       (Submission Deadline: May 17, 2011)
I wish to nominate: _____________________________________________________
                           Employee’s Name
__________________________________ ___________________________________
Title                                                          Department Name

Please check each criterion and provide SPECIFIC EXAMPLES beneath each as it applies to your nominee.
       
       Come up with new ideas to benefit their departments or the University or, create new applications for
       old ideas; they look for ways to transform the mundane into the magical.
        How? (Please provide specific examples - “like the time when…”)
         
         
         Understand their customers’ needs which stimulate them to think about new possibilities.
         How? (Please provide specific examples - “like the time when…”)
         
         
         
         Encourage suggestions to improve, eliminate, reduce, increase, or save.
             How? (Please provide specific examples - “like the time when…”)


         Consider mistakes learning opportunities.
         How? (Please provide specific examples - “like the time when…”)


         Actively communicate, sharing ideas with their coworkers on an ongoing basis.
             How? (Please provide specific examples - “like the time when…”)




If you would like to make any additional comments, please use the back of this sheet or an additional sheet and limit your
comments to 100 words or less.

Signature of Nominator                                                    Date Submitted

Printed Name of Nominator

Relationship (supervisor, student, co-worker, etc.)

Nominator’s campus address and phone number

You may suggest the name of another employee that would support the nomination of this individual. May we contact them?
 Yes     No

________________________________            ___________________________            __________________
Name                                            Department                              Phone Number