Civilian Employee of the Year Nomination Form

Section I - Nominee Information
Please complete all sections of the nomination form.
Date*
MM slash DD slash YYYY
Title*
Nominee's Name*
First Last
Agency*
Agency Size
Address*
Street Address City State ZIP Code
Email*
Phone*
Years of Service*
Supporting documents*
Drop files here or

Accepted file types: pdf, Max. file size: 20 MB.
Please provide a photo appropriate for publication.*
Accepted file types: jpg, gif, png, bmp, Max. file size: 128 MB.
Section II - Nominator Information
Rank/Title*
Name*
First Last
Agency*
Phone*
Email*
Section III - Endorsement
Rank/Title - This nomination must be endorsed by the Agency Head who is a member in good standing*
Agency*
Name*
First Last
Agency*
Name
This field is for validation purposes and should be left unchanged.

Section I - Nominee Information