Employee Recognition and Nomination Form

Eligibility: All Patchogue-Medford School employees may be nominated. Each nomination will be evaluated and remain in consideration for the duration of the school year.

Suggested Guidelines for Nomination:

Outstanding achievement/contribution in the workplace.
Displays excellence in the promotion of positive moral and a supportive attitude.
The employee works diligently to improve self and others.
The employee has demonstrated an initiative to enhance the school, office or District.

Employee's First Name: *

Employee's Last Name: *

Employee's Job Title: *

Employee's Department: *

Employee's Building: *

Please tell us how (give specific examples) this employee has demonstrated excellence above and beyond in his/her job. (Please limit your response to 150 words or less.) *

0/150 words

Your Name: *

Your Phone Number: *

Your Email Address: *