Please complete this form to submit your nomination. Include any relevant attachments or links.
Please note a photograph of the nominee will be required. Please refer to the awards policy for more information about use of the photo.
* Required field
*Select which award this nomination is for:
—Please choose an option—LeadershipMentoring & CoachingAllyInnovation
*Name of Nominator:
*Nominator Phone Number:
*Agency Approving Nomination:
*Senior Officer Approving Nomination:
*Nominee Phone Number:
Please attach a photo of the nominee:
*Photo attachment (supported file types: pdf, png, jpg):
Please attach a document with a Nominee Bio and Nomination Details. Nominee Bio is a brief personal summary about the nominee (max 250 words). Nomination Details include details regarding the situation, the nominee's involvement, and the outcome (max 750 words). Please follow the scoring rubric in the Selection Criteria documents.
*Nominee Bio and Nomination Details Attachment (supported file types: pdf, png, jpg):
You may also attach any supporting documentation, if you would like:
Supporting documentation (supported file types: pdf, png, jpg):
*Please confirm the following:
I confirm the information I have provided is true and accurate to the best of my ability.
I confirm I have consent from the nominee to submit this form and the details included for award consideration.
I confirm the disclosure of this information will not affect an ongoing, current investigation, criminal trial or the privacy of those involved.