Nomination Form The Award:We believe that employment is the foundation of personal and community stability. Goodwill seeks to recognize a local for-profit company that is exceptional at supporting individuals facing barriers to gaining and maintaining employment. Judging & Eligibility:An independent panel of judges comprised of human service and human resource professionals, civic leaders and academic professionals will select this year’s winner. The judges will evaluate the nominees’ efforts to create enhanced opportunities for marginalized and non-traditionalpopulations to be successful in the workplace. Nominees should be for profit public or privately held companies with 50+ employees. The Process:Please respond fully to each portion of every section and submit with supporting documents about the business you are nominating for the Power of Work Award by March 18th, 2016 via email to KAlcine@MoKanGoodwill.org or mail it to: 2016 Power of Work Awardc/o Klassie Alcine,Director of Community EngagementGoodwill of Western Missouri & Eastern KS1817 Campbell St.Kansas City, MO 64108PH. 816-842-3372 x297 About the Nominee (self-nominations accepted) Company Name* Mailing Street Address* City, State, Zip* Contact Name & Title * Contact Email * Telephone * Company Website* Nominated by (if other than Nominee) Please complete the next section only if the information is different from the "Nominee" information. Nominated By Address City, State, Zip Contact Name & Title Telephone Email SECTION I: NOMINEE INFORMATION 1. Please provide a general description of the business you are nominating, including the approximate number of total employees. (1,000 characters or less)* 2. Please indicate with a checkmark which group(s) of marginalized or non-traditional populations is associated with the nominee. (Please select all that apply.) Populations include: People with physical and/or mental disabilities Displaced workers Participants in welfare-to-work programs People who are homeless People with limited work experience People with limited education/training Older and younger workers Workers with criminal backgrounds Section II: Innovative Access 3. Briefly describe the nominee’s innovative efforts to remove barriers to employment, such as job description accommodations, flexible work scheduling, childcare assistance, transportation, work education, alternative workplace, support/training/mentoring, the creation of new jobs, etc.* 4. Briefly describe creative, successful efforts by the nominee to recruit, interview and hire individuals with barriers to employment and efforts to enhance job satisfaction, retention, and career advancement. Include specific results achieved by those efforts.* 5. Provide a brief “success story” about an employee who has attained Power of Work benefits through the efforts of the nominee.* Section III: Optional Material You are welcome to submit up to four separate items that are in a suitable format for photocopying in support of your nomination: Endorsement letters from human service groups or referral agencies Awards and citations Recruiting literature Personnel policies Advertisements or public relations materials I plan to send optional material to the email and/or address above to be considered with this nomination form.* YesNo Completed nominations and attachments must be received before the deadline of March 18, 2016.