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Staff Manual Guide 3113.14 Attachment A

 

INDIVIDUAL AWARD NOMINATION

 

Prepare a data sheet.

The instructions in parentheses describe the information to be entered. Use 8-1/2" x 11" paper. Do not exceed one page, and do not photo reduce. Left margin must be no smaller than 1.5 inches.

NOMINATION FOR FDA (NAME OF AWARD) INDIVIDUAL

1. Name, title, organization, and Social Security Number of nominee:

 

2. Proposed citation:

 

3. Pay plan, series, and grade of current position:

 

4. Current summary rating of record is:

 

5. Length of service with DHHS:
Length of service with FDA:

 

6. Listing of pertinent previous honors and awards:

 

7. Brief summary of education:

 

8. Brief summary of work experience:

 

9. Identification of award criterion/criteria under which nominated:

Prepare a narrative justification.

The instructions in parentheses describe the information to be entered. Use 8-1/2" x 11" paper. Do not exceed one page, and do not photo reduce. Left margin must be no smaller than 1.5 inches.

Page 2 - Narrative Justification - (Insert name of individual)

(Describe the nominee's achievement(s) or distinguished service, showing clearly the manner in which the nominee has met the award criterion/criteria identified on page one. The justification must include sufficient detail to provide reviewing/recommending committees with enough information to effectively evaluate the nominee's contribution(s). Some points to include, if applicable, are: impact of the achievement on Agency mission, function, or activity affected; level of effectiveness before and after the nominee's action(s); results obtained by the nominee's action(s), including any quantifiable evidence of improvement; and degree of ingenuity, innovation, or exceptional skill demonstrated by the nominee. DO NOT EXCEED ONE SINGLE-SPACED PAGE.)

INSTRUCTIONS FOR COMPLETING NOMINATION OF AN INDIVIDUAL FOR THE FDA AWARD OF MERIT, FDA COMMENDABLE SERVICE AWARD, FDA EQUAL OPPORTUNITY ACHIEVEMENT AWARD, OR FDA OUTSTANDING ACHIEVEMENT AWARD.

Page 1 - General - Left margin must be no smaller than 1.5 inches. - Limit to only one page and do not photo reduce.

Item 1. Provide name exactly as it should appear on award token/certificate/letter/ memorandum including any degrees used by the nominee.

Examples:

James O. Bond Suzanne E. Light, Ph.D.
Laboratory Director Research Chemist
Region VI, Dallas Office of Physical Sciences
Office of Regulatory Affairs Center for Food Safety and Applied Nutrition
000-00-0000 000-00-0000

Item 2. Provide a proposed citation of 25 words or less which summarizes the service or achievement which serves as the basis for this nomination. Begin the citation with words like, "In recognition of...," or "For..." and do not use personal pronouns such as his, her, their, etc. When formulating the proposed citation, take special care to ensure that it not only states what the award recognizes, but also that it is identifiable with the award criterion/criteria cited in Item 9.

Item 3. Examples: GS-318-6; WG-3511-4; GS-696-12; GM-1320-14; ES-696-04.

Item 4. Cite current summary rating of record; e.g., Excellent, Fully Satisfactory, etc.

Item 5. Self-explanatory.

Item 6. Self-explanatory.

Item 7. Self-explanatory.

Item 8. Self-explanatory.

Item 9. Refer to the pertinent FDA Staff Manual Guide on the award for which the nomination is being made and cite appropriate criterion/criteria. Examples:

Criterion B
Criteria B and C.

Page 2 - General - Left margin must be no smaller than 1.5 inches. Limit narrative to only one page single-spaced. Do not attach written testimonials or endorsements.

Transmit each nomination separately under cover of its own transmittal memorandum - see sample at Attachment D to this Guide.