Kaleta-Carruthers Innovation Award Nomination Form

Kaleta-Carruthers Nomination Form

Nominating Individual’s Contact Information

Name(Required)

First Last

Job Title(Required)

Company Name(Required)

Email Address(Required)

Relationship to Nominee(Required)

Phone Number(Required)

Nominee's Information

Name(Required)

First Last

Job Title(Required)

Company Name(Required)

Industry(Required)

Email Address(Required)

Phone Number(Required)

Please select the nominee's membership status:(Required)

Nominee’s Contribution & Leadership Information

Please provide as much detail as possible when answering the questions below.

1. Describe the integrated absence management program implemented or enhanced by the nominee. (max 500 words)  (Required)

2. How has the nominee demonstrated innovation, passion, creativity, tenacity, and risk-taking in their approach? (max 500 words)(Required)

3. Provide evidence of the program’s impact, including details on costs, savings, or other significant outcomes. (Required)

Drop files here or

Max. file size: 200 MB.

(Please attach any relevant documentation such as reports, data analysis, etc.) 

4. Why do you believe the nominee deserves the Kaleta-Carruthers Innovation Award? (max 300 words) (Required)

5. Additional Supporting Documents (Optional) 

Drop files here or

Max. file size: 200 MB.

Examples: Letters of Recommendation, Additional Testimonials, Press Releases or News Articles, Other Relevant Documents

6. I affirm that the information provided in this nomination is accurate to the best of my knowledge.(Required)

Yes

7. I agree that DMEC may contact me for additional information if needed.*(Required)

Yes

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