OMB Control Number: 0970-0477
Expiration Date: 3/31/2019 Information Collection for Specific Reviews
Review Title(s):___[To be completed by contractor]__________________________________________
Dates of Review(s): ):___[To be completed by contractor]______________________________________
Please fill out the table below:
Name: |
Address During Review Dates: |
Time Zone During Review Dates: |
Home Phone: |
Office Phone: |
Cell Phone: |
Preferred Email [please add “CONTRACTOR EMAIL”] to your approved list of addresses to prevent it going to spam): |
3-5 Areas of Expertise*: (see attached list) |
Race/Ethnicity (voluntary; see below for more information): PLEASE RESPOND BELOW |
Availability On All Review Dates: All days No, please explain: |
*Please also attach your latest resume or curricula vitae |
VOLUNTARY QUESTIONS: Diversity of Membership of Peer Review Panels
The Administration for Children and Families, U. S. Department of Health and Human Services is committed to increasing the diversity of the non-Federal peer reviewers utilized in the competitive grants review process to the extent permitted by law. You can help us achieve this goal by voluntarily indicating your race and/or ethnic heritage by checking the appropriate box for questions 1 thru 3. Please note that these questions utilize the standard Federal identification categories. Your assistance is invaluable in enabling the agency to promote broad representation, especially for underserved and underrepresented groups and track our progress on this important goal. The information will not be used in the selection of grant reviewers for Office of Planning, Research and Evaluation discretionary grant programs. The information will be used solely to monitor the diversity of our grant reviewer pool.
Voluntary - With which of the following racial classifications do you identify yourself? (Check all that apply)
__White
__Black or African American
__Asian
__Native Hawaiian or Pacific Islander
__American Indian or Alaskan Native
__Prefer not to answer
Voluntary - With which of the following ethnic classifications do you identify yourself?
__Hispanic/Latino
__Not Hispanic/Latino
__Prefer not to answer
Expertise Sheet 1: Early Childhood
Please check all areas of expertise.
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1. research methods |
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17. dual language learners/esl |
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33. cultural responsiveness |
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2. evaluation research/methods |
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18. special needs/developmental delays |
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34. other______________ |
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3. implementation research |
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19. low income families |
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35. other______________ |
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4. statistics/secondary analyses |
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20. American Indian/Alaskan native |
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36. other______________ |
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5. assessment/measurement development |
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21. Migrants/Seasonal farmworker families |
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37. other______________ |
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6. early education |
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22. parenting/parent-child interactions |
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7. child care |
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23.family engagement |
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8. child welfare |
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24. child behavior management |
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9. home visiting |
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25. social and emotional development/emotion regulation |
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10.Pre-k |
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26. school readiness |
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11. child care subsidies |
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27. health/nutrition/physical development |
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12. Head Start |
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28. language development |
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13. infants/toddler |
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29. literacy |
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14. preschool |
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30. math |
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15. homeless |
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31. program quality |
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16. foster care |
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32. professional development and training |
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Expertise Sheet 2: Welfare and Family Self-Sufficiency
Please check all areas of expertise.
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1. research methods |
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15. two-generation programs |
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29. impacts of resource scarcity |
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2. evaluation research/methods |
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16. job search services |
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30. executive functioning |
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3. implementation research |
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17. employment and the labor market |
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31. goal-setting and self-regulation |
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4. statistics/secondary analyses |
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18. workforce development |
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32. coaching interventions |
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5. assessment/measurement development |
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19. subsidized and transitional employment |
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33. case management |
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6. low-income families and children |
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20. career pathways |
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34. program quality |
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7. homeless families and homelessness |
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32. WIOA coordination |
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35. disparities in human services |
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8. American Indian/Alaskan native populations |
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33. education and training |
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36. cultural responsiveness |
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9. Migrants/Seasonal farmworker families |
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23. financial literacy |
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37. other______________ |
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10. poverty and income inequality |
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24. asset development |
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38. other______________ |
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11. family self-sufficiency and stability |
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25. behavioral economics |
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39. other______________ |
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12. social mobility |
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26. behavioral insights and applied behavioral sciences |
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40. other______________ |
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13. Temporary Assistance for Needy Families |
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27. behavioral interventions |
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14. public assistance benefits and the safety net |
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28. psychology or neuroscience |
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Expertise Sheet 3: Family Strengthening
Please check all areas of expertise.
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1. research methods |
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2. evaluation research/methods |
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3. implementation research |
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4. statistics/secondary analyses |
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5. assessment/measurement development |
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6. low-income families and children |
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7. marriage |
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8. marital conflict |
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9. relationship |
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10. other______________ |
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11. other______________ |
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12. other______________ |
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13. other______________ |
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Public reporting burden of this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Pangburn, Renee |
File Modified | 0000-00-00 |
File Created | 2021-01-14 |