Grant Panel Reviewer Interest Form

Mid-America Arts Alliance relies upon arts leaders in the field to serve as reviewers for various programs including Cultural Sustainability: Operational Impact Grants for Small Arts Organizations. A review of application materials followed by a review panel meeting is planned to take place in March or April. The meeting is held in a web-based format via Zoom. Therefore, reviewers must have a computer capable of browsing and online meetings as well as reliable internet access. Reviewers are not expected to travel; however, each reviewer must be able to commit to an independent review of applications in advance of the meeting. 

A stipend is provided based on the number of applications the reviewer completes as assigned.

Submitted panel service interest forms will be held for consideration for two years. If you have any questions or concerns, please contact Christine Bial, Director of Grant Programs at christine@maaa.org.




Reviewer Contact Information











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If applicable.

If applicable.



Reviewer Demographic Survey
In order to best serve the arts ecosystem, we are seeking a balanced panel of potential grant reviewers. Any information you provide will be used to ensure that the panel of reviewers is an equitable representation of artistic disciplines, organizational expertise, as well as a representation of the populations across our nation. 
Gender 
M-AAA does not discriminate on the basis of gender. This information helps us track the effectiveness of our outreach efforts. Please choose all options you are most comfortable with.

Age Range 
M-AAA does not discriminate on the basis of age. This information helps us track the effectiveness of our outreach efforts. Please choose all options you are most comfortable with.
Race/Ethnicity 
M-AAA does not discriminate on the basis of race/ethnicity. This information helps us track the effectiveness of our outreach efforts. Please choose the option you are most comfortable with.




Reviewer Qualifications/Expertise








If the artist is on a regional state arts agency roster, the link to that listing will suffice.




List only one personal reference. Include first and last name of the person, their title, email address, phone number, and related relevant affiliation. 
Reviewer Experiences




Certification
The interested party hereby certifies to the best of its knowledge and belief that it and its principals: 
  • is not presently declared ineligible, or excluded from receiving federal assistance from any federal agency;
  • does not currently owe a debt to the federal government for outstanding taxes;
  • has not, within a three-year period preceding this form's submission, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining or attempting to obtain public funds;
  • is not presently indicted for or otherwise criminally or civilly charged by a government entity with commission of any of the offenses noted above.
By virtue of checking the box below and submitting this form online I, the potential panelist, certify that all information contained herein is true.