Reviewer Registration Script_03.06.2020

Reviewer Registration Script:
Mandatory Information
Title (Drop Down Menu)
• Brother
• Dr.
• Hon.
• Min.
• Mr.
• Mrs.
• Ms.
• Miss
• Pastor
• Rev.
• Rev.Dr.
First Name
Last Name
Address
City
State (Drop Down Menu)
• Acronym for each state
Zip
Cell Phone Number
Home phone Number
Work Phone Number
Email Address
Are you a current Federal Employee? (Drop Down Menu)
• Yes or No
Are you a current Federal Contractor? (Drop Down Menu)
• Yes or No

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to select qualified reviewers for ACF review processes based on professional qualifications. 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. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information
subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number.
The OMB # is 0970-0477 and the expiration date is 04/30/2022. If you have any comments on this collection of information,
please contact info@reviewerregistry.net .

Education/ Experience:
Highest Degree Earned/ Discipline (Drop Down Menu)
• High School Diploma
• Undergraduate Degree
• Graduate Degree
• Post Graduate Degree
Do you have previous experience as a grant reviewer? (Drop Down Menu)
• Yes or No
Do you have previous experience as a panel lead? (e.g. Chairperson, Team Lead, Facilitator) (Drop Down
Menu)
• Yes or No
When did you last participate in a grant review? (Drop Down Menu)
• Never
• 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 (Drop Down Menu)
• Expertise Choice - Examples
o Adolescent Health
o Child Welfare
o Community Development
o Domestic/Family Violence
o Employment Services
o Low Income Individuals/Families
o Nonprofit/Community Organization Management
o Reentry/Recidivism
• Experience
o Less than 3 years of experience
o 3-7 years of experience
o 7+ years of experience
• Occupation (Most Recent) – Reviewers enter their most recent work history.
• Experience Details – Reviewers enter their most relevant job duties

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to select qualified reviewers for ACF review processes based on professional qualifications. 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. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information
subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number.
The OMB # is 0970-0477 and the expiration date is 04/30/2022. If you have any comments on this collection of information,
please contact info@reviewerregistry.net .

Resume Upload
Voluntary Information
What is your ethnicity?: (Drop Down Menu)
• Hispanic or Latino
• Not Hispanic or Latino
What is your race?: (Select One or More)
• American Indian or Alaska Native
• Asian
• Black or African American
• Native Hawaiian or Other Pacific Islander
• White

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to select qualified reviewers for ACF review processes based on professional qualifications. 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. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information
subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number.
The OMB # is 0970-0477 and the expiration date is 04/30/2022. If you have any comments on this collection of information,
please contact info@reviewerregistry.net .

FYSB Landing Page

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to select qualified reviewers for ACF review processes based on professional qualifications. 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. This is a voluntary collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information
subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number.
The OMB # is 0970-0477 and the expiration date is 04/30/2022. If you have any comments on this collection of information,
please contact info@reviewerregistry.net .