Template · Performance and development
Employee of the month nomination form
In short
An employee of the month nomination form is how coworkers and managers put forward a colleague for a monthly award. This template asks for the nominee, the criteria they met, specific examples and impact, then gives the selection committee eligibility checks and a scoring rubric, so winners are chosen on evidence rather than popularity.
Employee of the Month Nomination Form template
Employee of the Month Nomination Form
Anyone can nominate a colleague, including peers, team leads and managers. You cannot nominate yourself. Describe what the person actually did, with examples, dates and results where you can. Nominations close on the [day] of each month. The selection committee reviews every nomination using the criteria below.
Nominee
- Nominee name
- Job title
- Team / department
- Site / location and shift
- Nomination month
Nominated by
- Your name
- Your job title and team
- How you work with the nominee
- Same team, peerI manage themOther teamThey support my workCustomer feedback I received
- Share my name with the nominee if they win
- YesNo
Award criteria (select all that apply)
- Outstanding customer or patient service
- Exceeded performance targets (quality, productivity, sales, accuracy)
- Helped teammates or trained new hires
- Solved a problem or improved a process
- Stepped up in a difficult situation (peak volume, staff shortage, emergency)
- Safety leadership
- Lived our values: [Value 1], [Value 2], [Value 3]
What they did
- Describe what the nominee did this month. Be specific: what, when, who was involved.
- What was the result or impact? Include numbers if you have them (customer comments, scores, time saved, errors avoided).
- Why does this go beyond what is normally expected in their role?
- Supporting evidence attached or available (customer email, QA score, manager note)
- Nominator signature
- Date
Committee use: eligibility
- Employed at least [90 days]
- No active written warning or performance improvement plan
- Has not won in the last [12 months]
- Eligibility confirmed by HR
Committee use: scoring (1 = low, 5 = high)
- Specific, verifiable examples given
- 12345
- Impact on customers, team or business
- 12345
- Beyond normal job expectations
- 12345
- Reflects company values
- 12345
- Total score (out of 20)
- Committee decision
- WinnerRunner-up / honorable mentionNot selected this monthCarry forward to next month
- Committee notes
- Committee chair signature
- Date
How to use this template
- Set the criteria, eligibility rules, prize and nomination deadline before launch, and publish them with the form.
- Make the form available on paper and on mobile so frontline and shift workers can nominate, not only desk staff.
- Remind teams a week before the deadline and ask managers to encourage peer nominations, not just their own.
- Have HR check eligibility, then let a small rotating committee score each nomination on the rubric without seeing nominator names if possible.
- Announce the winner with the specific story from the nomination, and thank every nominee and nominator.
- Track winners by site, shift, team and demographic group each quarter to make sure recognition is spread fairly.
What makes a nomination form useful
The weakest employee of the month programs ask one question: "Who should win and why?" The answers are short, the same popular people win every few months and everyone else stops paying attention. A good form forces specifics. What did the person do, when, and what changed because of it? That gives the committee something to compare, and it gives the announcement a real story to tell.
The criteria section matters too. Tie it to the work people actually do. For a contact center, that might be quality scores, a difficult call handled well or helping new agents through nesting. For a warehouse, safety leadership and accuracy during peak. Generic criteria like "great attitude" reward visibility, not contribution.
Peer recognition versus manager-only nominations
Let peers nominate. They see things managers miss, especially on night shifts, at remote sites and in teams where the manager covers 25 or more people. Peer nominations also make the program feel less like a manager's favorite pick. Some organizations run a separate, lighter peer recognition form for quick thank-yous and keep the monthly award for bigger contributions.
Whoever nominates, the selection should be done by a small committee that rotates every quarter and includes at least one frontline employee. Removing the nominator's name before scoring reduces the influence of senior nominators. For broader context on making recognition stick, see our guide to employee recognition.
Prizes, taxes and fairness
Typical prizes are a reserved parking space, a gift card, extra paid time off, a certificate and a public announcement. Keep the prize meaningful but modest; a large cash prize turns the award into competition and resentment.
In the US, cash and gift cards are generally taxable wages, even small amounts, and should go through payroll. Some tangible non-cash gifts and certain achievement awards can be treated differently under IRS rules, so check with payroll before you choose prizes. Eligibility rules need care too. Excluding people on leave can disadvantage employees on FMLA, parental or disability leave; consider counting the months they worked. Review winners each quarter by location, shift, role, gender and race, and if one group never wins, look at the criteria and who is nominating. Rules vary by state and country.
Running it across multiple sites
A single company-wide winner from 2,000 employees across 12 sites means each person has almost no chance and frontline staff stop caring. Run the award per site or per department instead, with an annual company-wide award chosen from the monthly winners. Use the same form and rubric everywhere so results are comparable.
Collect nominations through a mobile form that works without a company email account, since many hourly employees do not have one. Announce winners in the shift huddle and on site screens as well as by email, using an employee recognition email. Link the program to performance data where you can: a winner whose performance review a month later reads "needs improvement" undermines both processes. Results from your employee engagement survey will show whether people feel recognized; ask that question directly.
Common mistakes
- Picking the winner before nominations close, or letting the same manager decide every month.
- Choosing someone just because "it's their turn." Everyone notices.
- No winner in a slow month because nominations were thin. Extend the deadline and remind people instead.
- Announcing the winner with "for being awesome." Share the specific story from the nomination.
- Forgetting the nominators. Thank them; they are the reason the program works.
Frequently asked questions
What should an employee of the month nomination say?
What the nominee did, with specific examples and dates, the result or impact, why it goes beyond normal expectations for the role and which award criteria or company values it reflects. Evidence such as customer comments or quality scores helps.
What are good employee of the month criteria?
Criteria tied to real work: customer or patient service, exceeding performance targets, helping or training teammates, improving a process, stepping up during a difficult period, safety leadership and demonstrating company values.
What is a peer recognition form?
A short form employees use to recognize a coworker's contribution, often without a formal award attached. It is lighter than an award nomination and can feed into monthly or annual award selection.
Can employees nominate themselves for employee of the month?
Most programs do not allow it, because the award is meant to reflect recognition from others. Some include a self-nomination option for annual awards, supported by a manager's endorsement.
Are employee of the month prizes taxable?
In the US, cash and gift cards are generally taxable wages and should go through payroll. Some non-cash gifts and achievement awards may be treated differently, so check with payroll or a tax advisor.