LANDIT Nomination Form (Manager) Thank you for your interest in the Landit pilot. The following are characteristics of ideal candidates: High potential for growth Self-Driven High performing Displays leadership traits Demonstrates Servant Leadership behavior by adhering to the tenents Shows enthusiasm and commitment to personal and professional growth Open to receiving and reacting to feedback Willing and able to commit to an action plan 2+ years of employment at National Life Group Please note: the pilot participant’s department will absorb the cost of the program - $1000The nominee will also be required to submit two professional references for consideration. Question Title * 1. Name of Nominee Name and Dept.: Extention E-mail Question Title * 2. Your Name Name Department Question Title * 3. How long has the nominee worked at National Life Group? Question Title * 4. Please describe why you feel this person would be a good fit for the program (500 words or less): Question Title * 5. Which Servant Leadership Tenet do they most strongly represent? Question Title * 6. Which one do they most need to develop? Question Title * 7. I agree that my AU will be charged $1,000 if the nominee is selected for the program. Yes No Question Title * 8. AU to be charged: Thank you for your interest in the program. Selected participants will be notified shortly. Done