An employee has submitted a nomination form for an annual ethics excellence award. The form requests the employee's name, code, designation, location, and selected rewards category. It includes spaces for the employee to provide a self-evaluation description of their achievements and score themselves on a scale of 0 to 10. The employee's department head will also evaluate and score the nomination on the same scale. The completed form requires signatures from the employee and their division/department head and must be submitted by November 23rd for consideration, with evaluated forms to HR by November 27th. Late submissions will not be accepted.

1. Nomination Form
Annual Rewards & Recognition (FY21)
Name Employee Code
Designation Designation
Location ( Section, Division, Circle)
Please select Rewards Category
Rewards Category Ethics Excellence Award (Non- Executive)
Assessment Parameters Self-Evaluation – Description
( Please mention details of achievements under different category with
supporting data & facts)
Self-Evaluation Score
(0 to 10 point scale)
Evaluation Score byDept. Head
/ Div. (0 to 10 point scale)
No of Ethical behavior
Voluntary - Proactive
How many reporting

2. Total Score
Comments of Division Heads / Circle Head / Department Head:
_______________________ __________________________________________________
Signature of Employee Signature of Division Heads / Circle Head / Department Head
1. Employee are advised to send filled self-nomination form to Division Heads / Circle Heads / Department Heads latest by 23rd November 2021
2. Division Heads / Circle Heads / Department Heads are advised to share evaluated form to respective Circle Nodal HR officer / Ms. Sonakshi Kumari on
or before 27th November 2021.
3. Forms submitted beyond stated dates shall not be accepted