2024 Assisted Living Service Excellence Nomination Form

NOMINATION PROCEDURES: Complete this form and submit it by clicking on the “submit” link at the bottom. Before you send the email, attach any supporting documents you wish to be considered by the judges. You are allowed up to 10 pages of supporting documents, and these should be submitted in the form of PDFs.

PURPOSE: This award recognizes a full-time employee of a Tennessee Center for Assisted Living (TNCAL) member facility for providing outstanding service to residents and the facility as a whole. Judging will focus on how the individual contributes to the physical and emotional well being of the residents; shows initiative and performs above the call of duty; has a positive attitude that boosts staff morale; and displays leadership and a high standard of ethical behavior.

ELIGIBILITY: Employees of a TNCAL member facility qualify for nomination in this category.

This form may be completed by either the nominee or the individual submitting the nomination.

Person Completing This Form:*

Email of Person Completing This Form:*

Name of Nominee:*

Title:*

Facility/organization:*

Years at Facility:*

Address:*

Street Address Address Line 2 City State ZIP Code

Nominated By:*

Title:*

Facility:*

Address:*

Street Address Address Line 2 City State ZIP Code

I have confirmed that the nominee plans to attend the Annual Convention & Trade Show with his/her facility.*

Yes
No

List two media outlets that should receive a press release about this nomination.*

Describe the nominee’s special accomplishments or any leadership roles the nominee fills at the facility.*

List several examples of how the nominee shows initiative and performs above the call of duty.*

Give specific examples of how the nominee shows a positive attitude and boosts staff morale.*

Describe how this nominee has provided outstanding service to residents and the facility as a whole. Give examples.*

Additional Supporting Files:

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 5 MB, Max. files: 10.

Accepted Formats: PDF, DOC, DOCX | Max # Files: 10 | Max File Size: 5MB

Name

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2024 Assisted Living Service Excellence Nomination Form

THCA/TNCAL Convention & Trade Show