Veronica Awards — Nomination Form

1.1. Superstar Awards are made to individuals who provide direct services to individuals and families. Please indicate the following about the nominee: (EXCLUSIVE CHOICE)

1.2. Indicate the program or programs in which he/she works (check all that apply):

1.3. What is the typical period of service for an individual or family in your program?

1.4. What is the typical size of the nominee’s caseload/cohort/class?

1.5. What is the typical frequency of contact and documented engagement with participants who are on the nominee’s caseload/cohort/class?


2.1. What is your organization's theory of change or philosophy? How do you apply this to YOUR work with clients and how do you know you are making a difference with your clients? Please provide at one example. (10 Possible Points)

2.2. (Recommend Supervisor Answers): Why is this nominee a Superstar? From a data and/or outcomes perspective, how does s/he compare to their peers? Please specify how the nominee uses data to monitor incremental progress, do something different based on data, and/or improve quality of service based on data. (10 Possible Points)

2.3. In a bulleted list, provide examples of outcomes you track that demonstrate the lasting changes you have with your participants. Please also provide how you measure these outcomes. Additionally, include examples of how you track the quality of services provided (which could also be participant satisfaction data, and/or program fidelity data.)

2.4. Most importantly, please describe how the nominee uses the data listed previously in order to adjust their work to improve each participant's achievement of intended outcomes. Be specific with examples. Provide a sense of how often data is reviewed, and how it is specifically applied to drive performance. (20 Possible Points)

2.5. Please provide three professional references who have worked with the nominee (at least one in a supervisory capacity). Please note: The Superstar Foundation will likely contact all three if you are in serious consideration for an award.


3.1. Based on the answers provided above, upload non-anecdotal evidence and/or data that draws attention to the nominee's effectiveness. Comparative data with other staff serving in the same role is encouraged. As possible, please ensure that data provided is attributable to the nominee. Our Superstar Judges have experience in the field of human services but the more simple the files are to understand (including labels, etc...) the better. ALL DATA MUST BE DE-IDENTIFIED- Please make sure that any data that you submit that shows individual client outcomes or performance is de-identified, meaning that it does not include anyone's name, address, phone number, Social Security number or any other data that can be associated with a specific individual or family. (60 Possible Points)

Our judging panel will use the following criteria to evaluate the data set: