Lake Superior State University
Lake Superior State University
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Human Resources

Employee Recognition Program

Nomination Ballot

(Download Ballot)

The following conditions apply to nominations for the 2016-17 Recognition Awards:

Eligibility: Any University employee or currently enrolled student is eligible to make two nominations for the annual awards: one from the ESP (support staff) group (includes clerical, maintenance, food service, and public safety positions), and one from the A/P non-union group (administrative/professional). Nominations may be made from within your department or from other departments.

Exclusions: The president, vice presidents, and members of the selection committee are excluded from receiving these awards. The selection committee serves four-year terms and is replaced in rotation by the individuals receiving the awards. Awardees are excluded from nomination while committee members.

Committee members for 2016-17 are: Arlene MacPherson, George Carlisle, Jackie Kellerman, Jerry Killips, and Sheri Garee and Karen Storey (last year’s winners). Committee members may submit nominations.

Awards: An outstanding service award will be presented to one support staff employee and to one A/P employee at the Annual Retirement & Service Awards Ceremony. The names of awardees will be listed on a universal plaque.

How to Nominate

Nominations: Please use this form to submit the name(s) of your nominee(s) with complete statements of your reasons for nomination for the criteria listed below. Your signature/electronic signature is required for verification of your status as employee or student and will be kept confidential. Additional statements may be made on page 3.

Deadline: Ballots will be accepted until Tuesday, February 28, 2017, 5:00 p.m. If you have any questions about the program, please contact one of the committee members listed above.

I nominate for the following reasons:

(When listing criteria, please give examples!)

Service time required - minimum of two years full-time or equivalent part-time service at LSSU in a regular position.


Each category will receive a score of 0-5 points, depending on quality of statement.

1. Contributions to the overall goals/mission of the University. Service to students and/or other employees (other than what is required in their normal work). Concern for the campus and availability to the campus community.

2. Positive attitude, good personnel relations, a team worker; integrity on the job, fairness, honesty; a good role model - image, conduct an inspiration to others (on and off campus)..

3. Master of their own job skills; consistency in good job performance.

4. Works at self-improvement; utilizes opportunities for professional development; takes advantage of available education/learning avenues.

5. Additional comments - these could include community service, an outstanding accomplishment or other personal achievements.

NOTE: One electronic signature per form is accepted. Those interested in providing support for nominees need to complete individual nomination forms.

Your Name: Date:

Check one that applies to you:

Student Supervisor Department Co-Worker Colleague

Do you grant permission for the employee to receive a copy of this nomination form if requested?

Yes No

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