Opportunity and Innovation Form



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EAC/AVI

O pportunity and Innovation Form

Contact Information


Full Name:

     

     

     

Last

First

M.I.

Division:

     

     

Work Address:

     

Employee #

Street Address




Work Phone:

(   )      

Alternate Phone:

(   )      

E-mail Address:

     

Have you discussed this opportunity and innovation with your supervisor and/or manager? Yes No

Type of Opportunity and Innovation


□ Process/Opportunity for Improvement □ Ideas and Innovations □ Question or concern □ Other

Describe the issue, activity, process, or service:

Suggest actions needed to improve:

List the benefits of the actions:







To be filled in by Opportunity and Innovation Form Panel


Date Received:

     

Submitted by:

□ EAC/UMS Rep □ Email □ Suggestion Box □ Web

Forward form to: □ UMS Rep to assess opportunities for continual improvement including preventative and corrective actions

□ Employee Advisory Council □ Human Resources □ Unknown (send to Director)



Assigned to:

     

Target Date:

     

Action Taken:

     

Results of Action Taken:

     

Approved by:

     

Date Resolved:

     

Record #:

     

Was the employee contacted with response?

□ Yes □ No

If this is a personnel issue please contact your AVI Human Resources Generalist

Document Number:AVI-FRM-EAC1 Eff. Date: 06/16/11 Revision Number: 1

Approved by: EAC Desc. Of Change: Initial Release



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