Office of Public Affairs

Merit Performance Award
Nomination Form

All fields are required.

Your Name:

Title:

Court/Agency/Organization:

Address:

Judicial District
(if applicable)
What's This?:

Telephone:

Email:

Nomination Applies To:

Name of Employee:

Title:

Court and Location:

District Executive /
Chief Clerk

Please Check Category:

	Acts of Heroism (On or off the job)
	Superior Work Performance (Includes courtesy toward co-workers and the public, initiative or creativity)
	Community Service and Humanitarian Pursuits (Benefit to the Community)
	Outstanding Educational Efforts (Recognizes substantial contributions in educating youth or the community about the law and our court)

Please explain why your candidate deserves to receive the Merit Performance Award:

Please review your information before clicking on the "Submit Nomination" button. Mail other relevant material which supports your nomination.

The OFFICE OF PUBLIC AFFAIRS
Gregory Murray
Office of Court Administration
25 Beaver Street, Room 866
New York, N.Y. 10004
or fax to (212) 428-2117