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* 1. 1. Name of Employee

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* 2. Nominated By & Contact Information

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* 3. Employee’s Immediate Supervisor

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* 4. Describe how this employee has demonstrated leadership excellence in their area of competency during the preceding year.

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* 5. Describe how this employee has exemplified our Mission, Vision, Core Purpose and Core Values.

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* 6. Describe how the employee has fostered a congenial and team-focused environment.

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