Arts Fort Worth · Grants Panelist Nomination

Nomination Type *

Self-Nomination

Peer-Nomination

Interest in Serving *

Please describe why you are interested in serving on an Arts Fort Worth grants panel.

Reason for Nomination *

Please explain why you have nominated this individual to serve as a panelist for Arts Fort Worth's Grants Program.

Panelist Contact Information

Name *

Prefix

First Name

Last Name

Suffix

Occupation *

Organization/Affiliation *

Mailing Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email *

Verify Email *

Preferred Phone *

Alternate Phone

Demographics

Race, ethnic background, and gender are considered to ensure that panel composition represents the diversity present in our community. (Completion of this section is optional.)

Race/Ethnicity

Gender

Relative Experience

Areas of Expertise *

Check all that apply.

Arts Administration

Arts Education

Dance

Media Arts/Film

Literary Arts

Music/Opera

Theater

Visual Art

Other

Resume or Bio *

Panelist Stipend

We value your time and expertise. Arts Fort Worth offers a $100 stipend for each of its panelists. However, if you are selected as a grant reviewer you may choose to forgo your stipend to benefit the Grants Program.

I choose to forgo my stipend

Nominator Contact Information

Nominator Name *

Nominator Email *

Verify Email *

Nominator Phone *

Certification

Have you read the panelist job description and responsibilities? *

Yes

No

Can you commit to the duties and time requirements as outlined? *

Yes

No

Date *

(mm/dd/yyyy)

Electronic Signature *

By clicking "I Agree" below, you certify that the information herein is correct to the best of your knowledge, including all attachments and supporting materials, and that the applicant has read and understands the eligibility, review, and reporting requirements as defined in the Arts Fort Worth Grant Guidelines. The applicant will expend any funds received as a result of this application solely for the described programs. Additionally, the leadership of this organization is aware of and makes reasonable effort to conform to generally accepted standards of nonprofit governance.

I Agree

I Disagree