2018 AEFLA Mesa Workforce Development Area Reviewer Request Thank you for your interest in serving as a peer reviewer for the Adult Education and Family Literacy Act (AEFLA) grant competition. By completing this survey, you will help the Adult Education and Family Literacy team ensure that qualified reviewers will be selected ans assigned to review teams. To be considered as a reviewer for AEFLA, you must complete this survey. Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. Address Question Title * 4. Current Employer Question Title * 5. Cell Phone or Home Phone Question Title * 6. Work Phone Question Title * 7. Email Address Question Title * 8. Geographic Representation Urban Suburban Rural Question Title * 9. Geographic Region Metro North Central Northeast Northwest Pikes Peak Southeast Southwest West Central Question Title * 10. Current Role Adult Education Program Director (Current) Adult Education Program Director (Former or retired) Adult Education Teacher (Current) Adult Education Teacher (Former or retired) Career and Technical Education (CTE) Educator/Administrator CDE Consultant Community College Educator/Administrator K-12 Agency Administrator Library Program Administrator Social Service Agency Administrator State Agency Program Manager or Consultant Workforce Development Program Manager or Consultant Other (please specify) Question Title * 11. Subject Matter ExpertisePlease indicate ALL of the areas of expertise which apply to you. Addressing the needs of special populations Adult Basic Education Adult ESL/ESOL Adult Secondary Education Assessment Career Pathways College and Career Transitions Developmental Education Family Literacy Fiscal Management/Budget Planning Grant Management Immigrant/Refugee Populations Instruction Leveraging of other grants and resources Needs Assessment Professional DevelopmentProgram Development Program Sustainability Workplace/Workforce Education Other (please specify) Question Title * 12. Are you currently employed by an entity intending to submit, or that has submitted, an AEFLA grant application in this competition? Yes No If yes, please briefly explain: Question Title * 13. 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, or has been, submitted in the AEFLA 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: Question Title * 14. Will your financial interests be affected by the outcome of the AEFLA grant competition? Yes No If yes, please briefly explain: Question Title * 15. Did you help prepare, or do you plan on helping to prepare, one or more applications that will be submitted in the AEFLA competition, even if you do not have a financial interest in the outcome of the competition? Yes No If yes, please briefly explain: Question Title * 16. The AEFLA review requires an approximate 15-hour commitment, including the time to read and score grant proposals between June 4 - June 12 and attendance at the in-person review from 9 am-4 pm on Wednesday, June 13, 2018. I am able to commit to this time frame Not available for these dates, but please keep me on the list for next time If not available, please briefly explain: Next