City of Wichita - City Manager Excellence in Public Service Awards

Excellence in Public Service Awards Nomination Form

This form must be used. Nomination must be made in the allotted space. No attachments are allowed. Nominations must be received by either the Wichita City Manager's Office, Sedgwick County Communications Office, or the Wichita Public Schools Communications Office no later than 5 p.m. on Friday, March 2, 2012.

There is also a PDF version of the form available if you wish to fill it out, print and mail it in instead of using the online HTML form below. Return the nomination form to:

City Manager's Office
455 N. Main
Wichita, KS 67202

Reporting Individual

Nominee Information Name of Nominee:
Job Title of Nominee:
Building:
Work Organization of Nominee:

Person Submitting Nomination Your Name:
Your Relationship to Nominee:
Daytime Phone Number OR Email:

The Excellence in Public Service Award is designed to recognize individuals who demonstrate outstanding work performance as well as service to the community. It is important that the person submitting the nomination clearly detail the performance of the nominee in each of the following categories and include examples when appropriate. The selection committee has only the information provided on this form to make its decisions, so please elaborate whenever possible.

Nominee's Work Performance

Describe the extent to which the nominee has demonstrated outstanding and exemplary performance beyond normal work responsibilities. Please provide examples of leadership qualities, team commitment, and innovative approaches in the workplace.

Work Performance

Nominee's Community Service

Describe the extent to which the nominee has made important investments of time and energy through participation in community activities and organizations. Be sure to include specific examples of the nominee?s volunteer activities for organizations, projects or events in our community.

Community Service