Employee Wellness Champion Nomination Form
Employee Wellness Champion Nomination Form
Please complete this form to nominate a colleague who exemplifies exceptional commitment to promoting wellness within the workplace. Your detailed responses will help us recognize and celebrate outstanding contributions to our company’s wellness culture.
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Nominator Information |
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Name |
[Your Name] |
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Department |
[Your Office Department] |
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[Your Email Address] |
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Contact Number |
[Your Contact Number] |
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Nominee Information |
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Name |
[Second Party Name] |
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Department |
[Nominee's Department] |
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[Nominee's Email Address] |
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Contact Number |
[Nominee’s Contact Number] |
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Nomination Details |
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Why are you nominating this person to be an Employee Wellness Champion? |
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Please provide examples of how the nominee has promoted health and wellness in the workplace. |
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Endorsements |
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It is recommended to have at least one endorsement from a colleague or supervisor to strengthen the nomination. |
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Endorser's Name |
[Second Party Name] |
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Relation to Nominee |
[Colleague/Supervisor] |
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Comments |
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Submit your nomination by [MM-DD-YYYY] to [Your Company Email] or through the internal nomination portal.
Nomination Deadline: [MM-DD-YYYY]
Thank you for participating in recognizing and encouraging wellness champions in our workplace!
