PSAYDN

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Enter Email Confirm Email

Phone*

Highest Degree Attained (A Bachelor's is required as minimum)*

Do you have any experience in reviewing local, state and/or federal competitive applications? If so, please list applications in text box below.*

Yes
No

Have you been involved in writing any local, state and/or federal competitive applications? If so, please list applications in text box below.*

Yes
No

Are you willing to conduct up to six grant reviews, if accepted?*

Yes
No

Professional and Personal Experience

Youth Development/Afterschool Program Experience. Please check all that apply.*

21st CCLC State Director/State Education Agency staff
21st CCLC Project Coordinator
Current or past 21st CCLC grantee
Employee of a Local Education Agency (LEA)
Teacher/administration
Parent
Other

Other (please list):

Please check any of the following grants/programs that you have reviewed and/or written.*

21st CCLC grant
STEM grant
Math Science Partnership Grant
Arts Grant (any)
Prevention Grants
State or federal education grants
National Science Foundation
Other

Other (please list):

Please check all that apply. I have experience and/or an area of expertise in the following areas:*

Check the level(s) at which you have professional experience in.*

Early Childhood
Elementary
Middle
High School
Higher Education
Afterschool/summer programs
Technical/vocational

Number of years of professional experience (Keep in mind, we require 3 years collective experience in education, grant writing, and or afterschool time programming).*

None
Up to 2
3-5
6-10
11-15
15+

Please upload a current resume. A resume is required to be considered.*

Drop files here or

Conflict of Interest Disclosure

Conflict of Interest Disclosure. We ask if you have a vested interest in any of South Dakota’s Public Schools that you disclose here. You will not be asked to read or score a proposal in which there is a real or perceived conflict of interest.

Disclaimer

I certify that I will not duplicate or share any of the reader training materials or grant applications that I am given access to during this process. As a reader, I will uphold myself to ethical standards and appropriate confidentiality. In addition, I certify that my answers are true and complete to the best of my knowledge. If this application leads to engagement as a reviewer for the Nita M. Lowey 21st Century Community Learning Center grant competition, I understand that false or misleading information in my application or reviews may result in my disqualification for candidacy or my release from the review panel and result in my honorarium not being paid.

Proposal Reviewers Sought for Nita M. Lowey 21st CCLC Grants, State of South Dakota

Minimum Requirements

Compensation

Application

Professional and Personal Experience

Conflict of Interest Disclosure

Disclaimer