U.S. Department of Education
Office of Innovation and Improvement
Investing in Innovation Fund (i3) Program
FY 2 011 P EER REVIEWER INFORMATION CHECKLIST
Thank you for your interest in serving as a peer reviewer for the Investing in Innovation Fund (i3) Program. By completing this checklist, you will help the i3 team ensure that relevant information which may not be included or easily gleaned from your resume is appropriately highlighted. This will assist us in making quality selections and assignments for review panels. To be considered as a peer reviewer for i3, you must complete this checklist and send it along with your resume (no more than 5 pages) in an email to . Please include within your resume a brief list of bullet points that highlight your expertise either in evaluation or in the absolute priorities for which you wish to be considered as a reviewer.
Please note that the Department of Education may retain your contact information for consideration as a peer reviewer for other grant competitions.
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I. GENERAL INFORMATION
First Name: Last Name:
Mailing Address :
Current E mployer :
Email Address : Cell Phone :
Home Phone : Work P hone :
II. CURRENT ROLE
Please select only ONE of the following:
State or district education official Social entrepreneur
PK -12 teacher or principal Strategy consultant
College or university educator Grant maker or manager
Evaluator Other (please specify _______________)
III. PRIMARY AREAS OF EXPERTISE
Please indicate ALL of the areas of expertise which apply to you. These are the areas for which you would be considered as a peer reviewer.
Absolute Priorities:
Supporting Effective Teachers and Principals
Promoting Science, Technology, Engineering, and Mathematics (STEM) Education
Implementing Standards and Assessments
Turning Around Low Performing Schools
Improving Achievement in Rural LEA’s
Evaluation:
Evaluating the Effectiveness of Educational Innovations
Note: For descriptions of the priorities in sections III and V, please see the Notices Inviting Application (NIA’s) on the Department of Education website at: .gov/programs/innovation/applicant.html.
I V . ATTRIBUTES and SKILLS
Please indicate ALL of the areas of expertise which apply to you:
I nnovation : Experience starting, leading, and/or supporting innovative projects or organizations
S trategy or Growth : Experience growing programs and replicating them in new settings, assisting organizations develop business models, creating plans for scale and sustainability, and building capacity to achieve goals
G rant Review : Experience reviewing grant applications and making funding recommendations
V. OTHER AREAS OF EXPERTISE
Please indicate ALL of the Competitive Preference Priorities in which you have expertise:
Improving Early Learning Outcomes
Supporting College Access and Success
Addressing the Unique Learning Needs of Students with Disabilities
Addressing the Unique Learning Needs of Limited English Proficient Students
Improving Productivity
Technology
V I . C ONFLICT OF INTEREST POLICY AND QUESTIONNAIRE
Please be aware that any individual selected as a peer reviewer for the i3 competition will be reviewed for possible, apparent, and/or actual conflicts of interest. All potential peer reviewers are required to respond to the following initial conflict of interest questions. The Department may contact potential peer reviewers with additional questions as appropriate.
The questions generally seek to obtain information about your professional experience(s), including any financial interest that you may have in any i3 application. If a potential conflict of interest is identified, the Department will consider whether the individual can participate as a peer reviewer in full compliance with all applicable Department policies and procedures. In this way, the Department is able to ensure the objective and efficient management and administration of the i3 program, which ultimately ensures the integrity of the Department's functions and the public's confidence in that integrity.
1. Have you agreed to serve as an employee or consultant, or otherwise provide assistance or advice, on any project for which funding is being sought in an application that will be submitted in the i3 grant competition, or have you been offered the opportunity to do so and not yet accepted or declined, based on whether a grant is awarded?
Yes
No
If yes, please briefly explain:
2. Will your personal financial interests be affected by the outcome of the i3 grant competition?
Yes
No
If yes, please briefly explain:
3. Did you help to prepare, or do you plan on helping to prepare, one or more applications that will be submitted in the i3 grant competition, even if you do not have a financial interest in the outcome of the competition?
Yes
No
If yes, please briefly explain:
VI I . AVAILABILITY
Please indicate ALL of the times that you are interested and available (note: your selections must correspond to the preferences you noted in item #III):
Absolute Priorities Reviewers:
Available for a 4-week period spanning from mid-August to mid-September 2011 (not full-time), working remotely and via teleconference (approximately two weeks to read applications and two weeks for panel discussion and submitting final comments/scores).
Evaluation Reviewers:
Available for a 4-week period spanning from mid-August to mid-September 2011 (not full-time), working remotely and via teleconference (approximately two weeks to read applications and two weeks for panel discussion and submitting final comments/scores).
Available for a 2-week period spanning from late September to mid-October 2011 (not full-time), working remotely and via teleconference (approximately one week to read applications and one week for panel discussion and submitting final comments/scores).
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