Corry Memorial Hospital

Employee of the Quarter Nomination

LECOM Health CMH Employee of the Quarter

Award Nomination Form

I am pleased to nominate:(Required)
First and last name of nominee
What is the nominee's job at Corry Memorial Hospital?
For what department does the nominee work?
Nominated by:(Required)
What is your name?
Please provide your email address so we can contact you if we have any questions about your nomination.
Values
Nominees should demonstrate our values:

Information About the Nominee

Describe and give specific examples of how this person demonstrated our values listed above.
Explain how this person added to the success of Corry Memorial Hospital.
(Optional)

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