Identification and Contracting is the first phase of The EXCEL Program. Herein, participant identifies whom it wants to participate in EXCEL and the benefit participant hopes the participant will derive. Moreover, participants gain an understanding and appreciation of the commitment they are making and express their motivation to participate. Please take a few minutes to complete the participant’s portion of the Nomination Form. Your supervisor is completing a companion form. Please complete the form at your earliest convenience. The EXCEL Program can only begin subsequent to our receipt of this form.

Demographic Information
First Name
Last Name
Name of Organization
City
Phone Number
Gender	Male Female
Age
Education	Select.... Non-degreed Bachelor's R.N. M.B.A. Ph.D. M.D. Other M.A.
Organization level	Select.... Manager V.P./Director Senior V.P. or higher
Functional Area	Select.... Customer Relations Finance H.R./Org. Development I.S. Legal Manufacturing Marketing/Sales Operations R&D/Technical
1.  What benefit do you hope to derive from your EXCEL experience?

2. How would you rate your motivation and openness to learning at this point in time? (1-low motivation to 10-high motivation) If your rate yourself "low," what accounts for this?  If you rate yourself "high," what accounts for your being open to learning at this point in time?

Select.... 1 2 3 4 5 6 7 8 9 10

3. Please describe the training and development experience from which you derived the greatest benefit? What do you think accounted for your positive experience?

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