Outstanding Performance Leave Award Nomination Form : Division of University Administration : Texas State University

Nominee: *

Name of person being nominated

Unit: *

Supervisor: *

Assistant Vice President: *

Hours: *

For awards greater than 16 hours, the Department Head must discuss with the Vice President.

The nomination is based on which of the following criteria: *

Check all that apply.

Carry out additional responsibilities for an extended but temporary timeframe.

Contribute to developing a new process that increases efficiency or effectiveness, reduces cost, or enhances the quality of services provided.

Contribute to developing a new program that significantly contributes to a strategic initiative.

Assist on a significant assignment or project that is not part of their normal work duties or assignments.

Exceed expectations in current role.

The action by which the nominations are based align with which of the following Texas State Shared Value(s) : *

Check all that apply.

Teaching and learning based on research, student involvement, and the free exchange of ideas in a supportive environment.

The cultivation of character, integrity, honesty, civility, compassion, fairness, respect, and ethical behavior in all members of our university community.

A commitment to service and leadership for the public good.

Continued reflection and evaluation to ensure that our strengths as a community always benefit those we serve.

Research and creative activities that encompass the full range of academic disciplines -- research with relevance, from the sciences to the arts, from the theoretical to the applied.

A diversity of people and ideas, a spirit of inclusiveness, a global perspective, and a sense of community as essential conditions for campus life.

Responsible stewardship of our resources and environment.

Describe in detail the actions by which the nomination is based: *