2002 Missouri State Council Benefits

2014 LEAD Award (Leadership, Excellence, Achievement and Dedication) Nomination Form

This prestigious award is given to recognize and honor a Missouri Human Resources professional who has achieved the highest level of Leadership, Excellence, Achievement and Dedication in the field of Human Resources. The Award recipient will be announced and recognized at the SHRM Missouri State Conference, August 6-8, 2014 at Tan-Tar-A.

Nominees must be a current member of SHRM, the Missouri State Council of SHRM or a SHRM Affiliated Local Missouri Chapter and will be evaluated based upon their individual contribution(s) to one or both of the following categories:

 Hold an outstanding record of contributions to the Human Resources profession as an innovator, advocate and/or thought leader.

 Hold an outstanding record of volunteer service to the profession through leadership in a SHRM Affiliated Local Missouri Chapter, the Missouri State Council of SHRM and/or SHRM.

Submission Deadline June 15, 2014

Submit to Lori Maher, MO SHRM Executive Director [email protected]

Step 1 - Nominee Information:

Nominee Name:

Job Title:

Employer:

Type of Business or Organization:

Address:

Email:

Office Phone: Cell Phone: Years of HR Experience:

PHR SPHR GPHR Certification: Other ______

SHRM Member Number:

Missouri Chapter Affiliation:

List the volunteer positions held in SHRM Affiliated Local Chapter, State Council and/or SHRM.

Step 2 - Attach a resume or bio for the nominee.

Step 3 - Complete the following questions:

1. Leadership - Describe leadership roles the nominee has performed in the community – local, regional, national or international in scope and relating to HR.

2. Excellence - List one or two of the most significant professional contributions the nominee has made to the HR field. Describe the scope and nature of each of these contributions.

3. Achievement - Describe the overall contributions the nominee has made that benefit either their employer and/or the profession, highlighting one or two new, outstanding approaches, innovations and creative ideas that have applied or do apply to HR situations.

4. Dedication - Describe the overall contributions the nominee has made to the HR profession by contributing their expertise or services to professional organizations such as SHRM, local chapters or business coalitions. Please highlight one or two particular contributions.

5. References - Provide the names and contact information for up to three (3) other individuals who could discuss the nominee’s professional accomplishments.

Step 4 - Nominator Information (self-nominations also accepted):

In what capacity have you known the nominee?

How long have you known the nominee?

Your Name

Employer

Job Title

Address

Office Phone Cell Phone

Date Submitted

Step 5 – Submit by June 15, 2014 Deadline

Submit application and resume/bio to: Lori Maher, MO SHRM Executive Director [email protected]