CED Reviewer Registration Form 3 final From ROCIS

OMB Control No: 0970-0477

Expiration Date: 03/31/2019

CED Reviewer Registration Form

The Community Economic Development (CED) program asks potential application reviewers to provide the information listed below via a web-based tool. This tool can be accessed at https://www.reviewerrecruitment.net/registration/index.asp. The sub-bullets listed below correspond to choices in drop-down lists or checkboxes included on the web form.

• Title

  • Dr.

  • Hon.

  • Min.

  • Miss

  • Mr.

  • Mrs.

  • Ms.

  • Pastor

  • Rev.

  • Rev. Dr.

• First Name

• Last Name

• Address Line 1

• Address Line 2

• City

• State

  • AL

  • AK

  • AZ

  • AR

  • CA

  • CO

  • CT

  • DE

  • DC

  • FL

  • GA

  • ID

  • IL

  • IN

  • IA

  • KS

  • KY

  • LA

  • ME

  • MD

  • MA

  • MI

  • MN

  • MS

  • MO

  • MT

  • NE

  • NV

  • NH

  • NJ

  • NM

  • NY

  • NC

  • ND

  • OH

  • OK

  • OR

  • PA

  • RI

  • SC

  • SD

  • TN

  • TX

  • UT

  • VT

  • VA

  • WA

  • WV

  • WI

  • WY

  • AS

  • FM

  • GU

  • HI

  • MH

  • MP

  • PR

  • VI

  • AA

  • AE

  • AP

  • UK

• Zip

• Email

• Password

• Phone

• Alternate Phone

• Are you a current Federal Employee?

  • Yes

  • No

• Are you a current Federal Contractor

  • Yes

  • No

• Organization/Employer

• Highest Degree Earned

  • High School Diploma

  • Undergraduate Degree

  • Graduate Degree

  • Post Graduate Degree

• Do you have previous experience as a grant reviewer?

  • Yes

  • No

• Do you have previous experience as a panel lead?

  • Yes

  • No

• When did you last participate in a grant review?

  • Never

  • Within the last 1-3 years

  • Within the last 4-6 years

  • Within the last 7-10 years

  • More than 10 years ago

• Please select a minimum of three (3) areas that best define your expertise:

  • Expertise Choice 1:

    • Abstinence 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

    • Employment Services

    • Fair Housing

    • Faith-Based & Community Org Mgmt. / Leadership

    • Families & Low Income Individuals

    • Family / Domestic Violence

    • Financial Education / Literacy

    • Financial Services

    • General Business for Non Profit

    • Health

    • Healthy Food Financing

    • Higher Education

    • Homeownership

    • Human Trafficking

    • Information Management / Data Analysis

    • Intermediary Lending

    • Legal Profession/Legal Services

    • Mental Health Services

    • Micro-Enterprise / Self-Employment

    • Microfinance/Micro lending

    • Monitoring/Evaluation

    • Mortgage/Lending

    • Native Americans

    • New Business Development

    • Nonprofit Management

    • Personal Experience as Refugee/Ashlee

    • Process Monitoring and Control

    • Quality Improvement/Control

    • Refugee/Ashlee Services

    • Refugees

    • Research / Evaluation

    • Revenue Development Strategies / Fundraising

    • Rural Development

    • Small Business / Entrepreneurship

    • Social Services

    • Social Work

    • Systems Development and Testing

    • Systems Integration

    • Tax Assistance / EITC Outreach

    • Training & Technical Assistance

    • Underwriting

    • Youth Counseling

  • Expertise Choice 2:

    • Same list as above

  • Expertise Choice 3:

    • Same list as above

  • Expertise Choice 4:

    • Same list as above

  • Expertise Choice 5:

    • Same list as above

• Upload Resume

• The questions listed as voluntary will not be used in the selection of grant reviewers for Administration for Children and Families’ discretionary grant programs. This information will be used solely to monitor the diversity of our grant reviewer pool.

• Click a check box to designate a selection:

• ☐--American Indian or Alaskan Native
  ☐--Asian or Pacific Islander
  ☐--Black, not of Hispanic origin
  ☐--Hispanic
  ☐--White, not of Hispanic origin.

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)

Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, 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.

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