FYSB Discretionary Grant Reviewer Recruitment Form (Previously approved, ongoing collection)

Reviewer Electronic Registration Script

Mandatory Information
Title [Dropdown list]
First Name [open field]
Last Name [open field]
Address [open field]

[Title]
-Select OneBrother
Dr.
Hon.
Min.
Miss
Mr.
Mrs.
Ms.
Pastor
Rev.
Rev. Dr.

City [open field]
State [Dropdown list]

[State]
-Select OneAlabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois

Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada

New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas

Utah
Puerto Rico
Vermont
United Kingdom
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Armed Forces the Americas
Armed Forces Europe
Armed Forces Pacific
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands

Zip Code [open field]
Cell Phone Number [open field]
Home Phone Number [open field]
Work Phone Number [open field]
Email Address [open field]
Reviewer Electronic Registration Script

Are you a current Federal Employee? [Dropdown list]

[Federal Employee]
-Select OneNo
Yes

Are you a Federal Contractor? [Dropdown list]

[Federal Contractor]
-Select OneNo
Yes

Education/Experience
Highest Degree Earned / Discipline [dropdown list]

[Degree]
-Select OneHigh School Diploma
Undergraduate Degree
Graduate Degree
Post Graduate Degree

Do you have previous experience as a grant reviewer? [Dropdown list]

[Review Experience]
-Select OneNo
Yes

Do you have previous experience as a panel lead? [Dropdown list]
(E.g. Chairperson, Team Lead, Facilitator)

[Leader Experience]
-Select OneNo
Yes

When did you last participate in a grant review? [Dropdown list]

[Participation]
-Select OneNever
Within the last 1-3 years
Within the last 4-6 years
Within the last 7-10 years
More than 10 years ago

Reviewer-selected
Expertise
Designation

Resume Upload
[Upload accepted]

[Expertise]
-Select OneAbstinence Education
Adolescent Health
Affordable Housing Finance
Asset Building
At-Risk Youth
Banking/Finance
Business Expansion
Capacity-Building
Child Care
Child Services
Clinical Services
Collaboration Among Nonprofits
Communities
Community Development
Community Facilities
Consumer Finance
Credit Unions
Crisis Intervention / Transitional Housing
Cultural Diversity
Economic Development

Education
Native Americans
Employment Services
Mortgage/Lending
Fair Housing
New Business Development
Faith-Based & Community Org Mgt / Ldrshp Nonprofit Management
Families & Low Income Individuals
Personal Experience as Refugee/Asylee
Family / Domestic Violence
Process Monitoring and Control
Financial Education / Literacy
Quality Improvement/Control
Financial Services
Refugee/Asylee Services
General Business for Non Profit
Refugees
Health
Research / Evaluation
Healthy Food Financing
Revenue Dev't Strategies / Fundraising
Higher Education
Rural Development
Homeownership
Small Business / Entrepreneurship
Human Trafficking
Social Services
Information Management / Data Analysis Social Work
Intermediary Lending
Systems Development and Testing
Legal Profession/Legal Services
Systems Integration
Mental Health Services
Tax Assistance / EITC Outreach
Micro-Enterprise / Self-Employment
Training & Technical Assistance
Microfinance/Microlending
Underwriting
Monitoring/Evaluation
Youth Counseling

Reviewer Electronic Registration Script

Voluntary Information
Which of the following do you identify yourself with? [Dropdown list]

[Identity]
-Select OneAmerican Indian or Alaskan Native
Asian or Pacific Islander
Black, not of Hispanic Origin
Hispanic
White, not of Hispanic Origin

Appendix Also Attached.

Reviewer Electronic Registration Script