RISE! Achievement Award Nomination Form 2016-17 (October 1 - March 31)

Welcome! This nomination form will prompt you to provide information about the achievement that you are nominating. However, if you have not already done so, please take a moment to read through the nomination greeting page on the Human Resources intranet site on StarNet to ensure that you are prepared for the nomination process.

NOTE: If you would like to submit additional details and/or supporting documentation for the award nomination, please email EmployeeRecognition@RichmondGov.com with that information after you have submitted this form. Be sure to include the name, professional title, and department/agency of the nominee(s) in your email.



A red asterisk (*) indicates required questions.


  1. Who are you nominating? Please list their names(s) and department(s):*


  1. Award Category (select one)*
    Exceptional Customer Service (Individual or Group Award)
    Process Improvement (Individual or Group Award)
    Outstanding Leadership (Individual Award)
    Safety/Heroism (Individual or Group Award)
    Individual Accomplishment (Individual Award)


  1. Award Type (select one)*
    Individual (1 person)
    Group (2-10 people, unless otherwise approved by HR)


  1. Who are you? Please list your name and department:*


  1. What is your work relationship with the nominee(s)?*
    Co-worker - I work with the nominee
    Direct Supervisor - I supervise the nominee
    Subordinate - I work for the nominee
    Management (not direct supervisor)
    Multiple relationships - Team Award


  1. Achievement Date: Please provide the approximate date (month, day, and year) of achievement completion.*


  1. Achivement Description: In 200 words or less, please provide a concise summary of the achievement that is being nominated. Sample descriptions are located on the Human Resources intranet site on StarNet.

    Note: If this is a nomination of a group, please try to identify the nature of each member's specific contribution. Each member's level of impact on the group achievement should be significant in some way. *