Indian Health Service (IHS) Potential Grant Application Reviewer Information Form

Become a Grant Reviewer

If you are interested in becoming a reviewer for an IHS funding opportunity, please complete the following information and submit this form for review by the Indian Health Service, Division of Grants Management.

Contact Information

First

Last

Email Address

Phone (Primary)

When may we use this number to reach you?

Daytime

Afternoon

Evening

Phone (Secondary)

When may we use this number to reach you?

Daytime

Afternoon

Evening

Address

Street Address

City

State

Zip Code

Funding Opportunities you are interested in reviewing:

Professional Experience

Brief professional experience or qualifications that enable you to be a reviewer.

Please upload your resume and do not exceed the five-page limit. Please provide your resume in one of the following formats:

One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.