PUBLIC SERVICE RECOGNITION WEEK (PSRW)
Do you know a state employee who deserves recognition for outstanding service? The Extra Mile Award is designed for Washington State citizens and employees to nominate an individual or group who surpasses expectations for exemplary public service. Employees shall demonstrate: innovative techniques and methods; outstanding leadership; visionary thinking; personal valor or bravery; outstanding customer service; etc.
Approximately 10 to 15 people will be selected and honored with this award.
(Please nominate only one individual or team per nomination form.)
Nominee: Number of Team Members:
Agency:
Phone: Fax: Email:
Mail Stop or Address:
County of Employment: County of Residence:
Representing (Institution/Division/Region):
Supervisor (of nominee): Phone:
Team Contact (of team): Phone:
Nominator: Representing:
Phone: Fax: Email:
In 300 words or less, provide a narrative explaining why this person or group is being nominated. Include specific examples and use additional paper if necessary. Please print or write legibly. (Nominations will be judged on the strength of the examples given.)
Applications due by 5:00 P.M. Friday, April 17, 2015.
Review of nominations will begin Monday, April 6.
We recommend submitting nominations as soon as possible.
E-mail this completed nomination form to:
psrw@ofm.
For questions, please use email above or call (360) 407-4149
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2015 Extra Mile
Award Nomination Form
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