2008 Memphis Regional
Quality Cup Nomination Form
(Based on the former RIT/USA Today Quality Cup Award and Baldrige Criteria.)

Before completing this nomination form, please read through the entire form.
Note the instructions and follow them carefully.
No nominations will be accepted without the $250.00 fee or after the November 19, 2008, deadline.

Please type or print:

1. Name of the team you are nominating: ______________________________________________

2. Name of the organization submitting the nomination: ____________________________________

3. Person who can respond to questions about this nomination:

Name (typed or printed): ________________________________  Title: _____________________

Company: _____________________________ Address: _________________________________

City, State, Zip: _________________________________________________________________

Telephone: ___________________ FAX: ___________________ Email: ____________________

4. Nomination Category: Check the category in which the nomination is submitted. The category is determined by the principal activity of the organization that employs the nominees.

_____ a. Education: All educational institutions, including K through 12, two and four year colleges, universities, and technical institutes. Not-for-profit, government operated, and proprietary institutions are all eligible.

_____ b. Government: All units of federal, state and regional government. It does not include for-profit firms devoted to providing services or manufactured goods to government units.

_____ c. Health Care Organizations: All providers of health care, including, but not limited to, hospitals, nursing homes, HMOs, and health care practices. Not-for-profit, government operated, and proprietary organizations are all eligible.

_____ d. Manufacturing Industry: All for-profit manufacturing firms with more than 500 employees. Subsidiary service firms, wholly owned by manufacturing firms and offering services to external customers, should be submitted in the service category.

_____ e. Service Industry: All for-profit services with over 500 employees. Subsidiary manufacturing firms, wholly owned by service firms and offering manufactured products to external customers, should be submitted in the manufacturing category.

_____ f. Small Business: All for-profit manufacturing and service firms with 500 or fewer employees. In counting the number of employees, include those employed by any parent company and all divisions and subsidiaries.

*To help us verify the category you have chosen, please describe briefly the products/services offered by your organization.

___________________________________________________________________________________

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The sponsors reserve the right to reclassify the nomination if doing so will place it in competition with a significant group of similar nominations. Dr. Donald Fisher, (901) 543-3551, can help if you are uncertain about which category to check.

5. Total team members:    

List the names and job titles of the team members, starting with the team leader. A team may include members who are not employed by the nominating organization, such as employees of a supplier or customer. Use an additional sheet of paper, if necessary, to list them all.

• OBSERVE THE WORD LIMITS
• PROVIDE A WORD COUNT FOLLOWING EACH RESPONSE

These are included in the criteria the judges consider. Additional exhibits, amounting to as many as six 8 ½ x 11 pages, may be used to supply supporting statistical evidence in tabular or graphic form. It is expected that statements made in response to these questions are verifiable and that nominees will be prepared to provide verification if it is requested.

6. Brief description: In no more than four hundred words, summarize the quality improvement for which this team is being nominated.

7. Process (400 Points): In no more than four hundred words, describe the process that led to the quality improvement. In scoring this section, judges consider the appropriateness of team composition and its empowerment, the appropriate employment of quality tools, customer-driven goals, the role of leadership, reproducibility of the quality improvement process, and commitment to continuous improvement.

8. Measurement (200 Points): In no more than two hundred words, describe the data and the method of analysis you used to measure the magnitude of improvement, and explain your choice of data and method. The judges will consider the relevance of the data and the appropriateness of the method of analysis. They will not expect more complexity than required for good measurement.

9. Result (400 Points): In no more than four hundred words, describe the improvement, its impact on the organization, the customers who benefit, and the magnitude of the benefit.

10. Briefly, is there anything else we should know about this team?

11. Release: Quality Cup nominations provide valuable illustrations of processes for achieving and measuring quality, continuous improvement, and customer satisfaction. Please indicate whether you are willing to allow such use of your nomination.

_____ a. Information in the nomination may be used for the purpose of teaching and research.

_____ b. Information in the nomination may be used for the purpose of teaching and research, but only after I have had an opportunity to review the use to which it will be put.

_____ c. Information in the nomination may not be used for teaching or research.

12. Signature of an officer or executive whose span of authority includes the nominee.

Signature: _____________________________________________ Date: _______________

Name (typed or printed): _____________________________________________________

Title: ____________________________________________________________________

Company: ________________________________________________________________

Address: _________________________________________________________________

Telephone number: _________________________ Fax number: _______________________

E-mail address: ______________________________

Mail the signed original, along with three copies, and the $250.00 nomination fee, payable to MSQPC - The Quality Center.

Dr. Donald C. Fisher
Executive Director
MSQPC - The Quality Center
22 North Front, Suite 200
Memphis, TN 38103

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