Safety Person of the Month Nomination Form

Use this Safety Person of the Month (SPOTM) nomination form to recognize employees who proactively identify and control hazards. Capture key details including employee and department information, team leader, date of observation and submission, the concern identified, and the hazard controlled. Select common hazard types such as laceration, blocked exits, crush, slip/trip/fall, burn, fire, explosion, or specify other. Document how and when the concern was corrected and record the completion date. This simple, structured workflow supports EHS recognition programs, strengthens safety culture, and drives continuous improvement—especially in manufacturing environments with higher-risk tasks and equipment.