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Research and Projects Panel Application


Instructions: Please fill out this form online and submit it using the "Send Form" button.

IMPORTANT NOTE: You are limited to 1,000 words. Anything over 1,000 words will not be accepted.

Panelist's participation on teleconferences is based on Eastern Standard Time.

Name  

Street Address 

Line 2 

City  

State  

ZIP  

Home phone  

Business phone  

Fax  

E-mail  


EDUCATION (include institution, degree, year conferred, and field)



PROFESSIONAL EXPERIENCE (starting with present position)

RESEARCH, SOCIAL POLICY, OR OTHER AREAS OF PROFESSIONAL INTEREST

CIVIC, COMMUNITY OR PROFESSIONAL ACTIVITIES RELATED TO EDUCATION AND EQUITY FOR WOMEN AND GIRLS



MEMBERSHIP IN PROFESSIONAL ORGANIZATIONS

GRANTSMAKING OR PROJECT ADMINISTRATION EXPERIENCE (Including planning, budgeting, and evaluation):

AAUW EXPERIENCE


PREFERENCE

Community Action Grants
Career Development Grants
Either

Optional: To help AAUW assure that there is diversity on all committees and panels, please indicate the underrepresented group of which you are a member, as stated in AAUW's diversity statement: In principle and practice, AAUW values and seeks diversity. There shall be no barriers to full participation in this organization on the basis of gender, race, creed, age, sexual orientation, national origin, disability, or class.




SIGNATURE OF RECOMMENDER (OPTIONAL)*

TITLE

* Recommender not required for self-nomination.



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