FORM 01: NOMINATION FORM

PUBLIC SERVICE COMMISSION

PUBLIC SERVANT OF THE YEAR AWARD

NOMINATIONFORM

SECTION 0: INSTRUCTIONS:

  1. The role of the Ministerial Human Resource Advisory Committee (MHRMAC)is to select twonominees (1 Male, 1 Female) from among staff across all cadreswho, in the informed judgement of the members of the committee meet the set criteria.
  1. Further information on eligibility and award criteria, rationale, nomination process and evaluation, can be found on the Award Concept Brief(DOC 01) on the PSC website at ( )

Submission of Ministry Nominations

  1. Submission Format: For each of the two nomineesfrom a Ministry the MHRMAC will type all the information required in the MS-WORD format of this form. The nomination form (FORM 01) is available at
  1. Supporting Evidence: All submitted nominations to be accompanied by relevant evidence/supporting materials on each achievement area (See Section 3).
  1. Naming the File: The File name for each nomination should take the following form; Nominee (Insert Name of nominee in parenthesis). Nominating Ministry (Insert the name as the Ministry making the nomination in parenthesis).
  2. Each of the two nominations selected by a ministry shall be accompanied a Curriculum Vitae of the nominee (CV).
  1. Submission Channel: Duly completed and e-signed nomination forms from each Ministry to be submitted through the following E-Mail address:

Page 1 of 4

FORM 01: NOMINATION FORM

SECTION 1: IDENTITY OF THE PERSON SELECTED BY MHRMAC FOR THE AWARD

NOTE: Please ensure that all sections marked with Asterisks (*) are completed.

* Surname
* Other Names
*Gender / Male / Female
* PF-NO:
*Position/Title
Ministry / State Department
Mobile No. / E-Mail
*Date of First Employment in the Public Service

SECTION 2: DETAILS OF MINISTRY SUBMITTING THE NOMINATION

To be signed by the Chair of the Ministerial Human Resource Advisory Committee (MHRMAC)before submission.

Name of Submitting Ministry
Chair MHRMAC
Signature / Date

SECTION 3: DESCRIPTION OF THE ACHIEVEMENTS OF THE PERSON NOMINATED BY THE MINISTRY FOR THE AWARD

COMPONENT 1: Contribution to change /transformation at the workplace.
In what ways has the nominee made significant contribution to change/transformation at the workplace?
COMPONENT 2: Contribution in mentorship, empowerment coaching and support to colleagues in the organization/workplace.
How has the nominee contributed to mentorship, empowerment coaching and support to colleagues in the organization/workplace?
COMPONENT 3: Record in Ethical Practice and upholding the values and principles of public service in article 232 of the Constitution.
What is the nominee’s record in ethical practice and upholding the values and principles of public service in Article 232 of the constitution?
COMPONENT 4: Innovation in service provision in the organization
Has the nominee made any contribution in service provision innovation in the organization?
COMPONENT 5: National or International Award or recognition / major contribution under extra ordinary circumstances / achievement of major milestones in primary role in the organization
Has the nominee: received a National or International Award or recognition? / made a major contribution in the organization or wider public service under extra ordinary circumstances? / achieved major milestones in their primary role?

END OF FORM 01

Page 1 of 4