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* 1. Today's Date:

Date

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* 2. I nominate the following employee for a High Five Award:

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* 3. The High Five award recognizes an exclusive number of employees for contributing in some extraordinary way to enhancing the quality of life for residents, clients, family members or employees.  The nominee has demonstrated one or more of the following five pillars of the High Five Awards:  (Please Select):

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* 4. Describe Achievement:

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* 5. What is your name?

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* 6. I am a:

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