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Free form template · Word

Employee Nomination Form

An employee nomination form lets a manager or colleague nominate an individual for a periodic recognition such as Employee of the Month or Quarter. It captures the nominee's performance evidence and behaviour examples so the selection panel can compare nominees fairly.

  • Editable Word (.docx)
  • Made for India
  • 14 fill-in fields highlighted
  • Free, no sign-up

Preview of the form

[Highlighted] = fill in
[Company Logo][Company Name]

EMPLOYEE NOMINATION FORM

Recognition:
[Employee of the Month / Quarter]
Period:
[Month / Quarter YYYY]
Submission Deadline:
[DD/MM/YYYY]

1. Nominee Details

Employee Name
Employee ID
Designation
Department
Work Location
Date of Joining
Reporting Manager

2. Nominator Details

Nominator Name
Employee ID
Relationship to nominee (Manager / Peer / Internal customer)

3. Performance During the Period

KPITargetAchievedSource of Data
[KPI 1][Target][Result][MIS / Report]
[KPI 2][Target][Result][MIS / Report]
[KPI 3][Target][Result][MIS / Report]

4. Behaviour Examples

Example 1 (what happened, when, and the result)
Example 2 (what happened, when, and the result)
Company value demonstrated

5. HR Eligibility Check

  • Completed minimum service of [Number] months
  • No pending disciplinary proceedings
  • Attendance meets programme rules
  • Not awarded the same recognition in the last [Number] months

Declaration

I confirm that the information in this nomination is accurate to the best of my knowledge and is based on first-hand observation or verified data.

Nominator
[Nominator Name]
Date: [Date]
Endorsed by
[Reporting Manager]
Date: [Date]
HR Verification
[HR Name]
Date: [Date]

What this template includes

  • Nominee and nominator details
  • Recognition period
  • KPI performance table
  • Two behaviour examples with dates
  • Attendance and conduct confirmation
  • Manager endorsement and HR eligibility check

When to use it

  • Monthly or quarterly Employee of the Month/Quarter cycles
  • Peer nominations for team-level recognition
  • Branch or plant recognition where many supervisors nominate
  • Building a documented trail for later awards

How to customise this template

  1. 1Replace KPI rows with role-specific measures
  2. 2Set a nomination deadline in the header
  3. 3Add an eligibility rule such as minimum service
  4. 4Make the manager endorsement optional for peer nominations
  5. 5Collect forms via email or a shared form

HR tips

  • Ask for examples, not adjectives
  • Check there is no pending disciplinary matter before award
  • Limit each nominator to one nomination per cycle
  • Share selection outcomes with all nominators

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Frequently asked questions

What should an employee nomination form include?+

Nominee and nominator details, the period, performance evidence, behaviour examples and manager endorsement.

Can employees nominate themselves?+

Most programmes do not allow self-nomination for individual awards, but some accept self-submitted achievement summaries. Define this in your guidelines.

How is this different from an award nomination form?+

An employee nomination form is typically for regular, periodic recognition, while an award nomination form is used for annual or category awards judged by a jury.