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 Name: *

Last Name: *

Email Address: *

Phone (Primary): *

When may we use this number to reach you? *

Daytime

Evenings

Anytime

Phone (Secondary): *

When may we use this number to reach you? *

Daytime

Evenings

Anytime

Street Address: *

City: *

State: *

Zip code: *

Please see our Web page for current Funding Opportunities, at http://www.ihs.gov/dgm

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: MSWord (doc, docx), Adobe (pdf), txt, rar, zip, jpeg *New file *

More information

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf pdf doc docx rar zip.