EFNEP AWARDS NOMINATION FORM

NOMINEE NAME(S):

COUNTY:

Check the one (1) award category for which the nominee is to be considered:
Over the Mark Award
New Extension EFNEP Program Assistant Award Performance Rating for previous year Hire Date: / /
Team Award
Golden Star Award
Social Media Award
Outstanding Performance Award Performance Rating for Previous Year Hire Date: / /
Circle of Excellence Award – Level 1 Performance Rating for previous year Hire Date: / / Year received Outstanding Performance (yyyy) Circle of Excellence Gold Award – Level 2 Performance Rating for previous year Hire Date: / / Year received Circle of Excellence (yyyy) Circle of Excellence Diamond Award – Level 3 Performance Rating for previous year Hire Date: / / Year received Circle of Excellence Gold (yyyy) Circle of Excellence Platinum Award – Level 4 Performance Rating for previous year Hire Date: / / Year received Circle of Excellence Diamond (yyyy) (continued)
EFNEP Endowment Program Support Award Performance Rating for previous year Hire Date: / /
Lorelei Aldridge Jones Educator Support Award Performance Rating for previous year Hire Date: / /
Susan McCaskill Morgan Professional Development Award Performance Rating for previous year Hire Date: / /
Ngaire van Eck Professional Development Award Performance Rating for previous year Hire Date: / /
MINNIE MILLER BROWN Award Performance Rating for previous year Previous recipient of Circle of Excellence, nominated for Minnie Miller Brown award. Year received Circle of Excellence (yyyy)

Submit 1 pdf that includes entire award packet (Cover page, Summary, Narrative, and Supporting Documents) to Grenita Jordan, EFNEP University Program Associate via email at grenita_jordan@ncsu.edu by August 15. Incomplete packets will not be considered for award. A confirmation of receipt only will be sent via email to the EFNEP Regional Nutrition Extension Associate.

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Nominator’s Signature	Date

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EFNEP Regional Nutrition Extension Associate’s Signature	Date

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County Extension Director’s Signature	Date