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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
City
State
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
Artistic Experience
Areas of Expertise
*
Check all that apply.
Arts Administration
Arts Education
Dance
Media Arts/Film
Literary Arts
Music/Opera
Theater
Visual Art
Other
Biography
*
Brief summary of the nominated individual's professional background and relevant experience.
Resume
*
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
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