OMB Control No. 0690-0038 Expiration Date: 07/31/2026
Privacy Act Statement
Authority: The collection of this information is authorized under 5 U.S.C. § 301, Departmental regulations which authorizes the operations of an executive agency, including the creation, custodianship, maintenance and distribution of records, and 15 U.S.C. 1512, Powers and duties of Department.
Purpose: NOAA is collecting information about individuals who are interested in reviewing applications for the Young Changemakers Fellowship. Interested individuals will provide information about themselves and the time that they have available to commit to reviewing applications. Those who fill out this form will be contacted with details on the process for reviewing applications for the Young Changemakers Fellowship Class of 2024-2025, and may be contacted beyond this year with optional opportunities to review future application classes.
Routine Uses: The information collected will be used to determine individuals’ interest in and time available for reviewing applications for the Young Changemakers Fellowship opportunity. It will also ask for basic information about these potential reviewers, with the ultimate goal of assigning a range of reviewers to read and rank each fellowship application. Disclosure of this information is permitted under the Privacy Act of 1974 (5 U.S.C. Section 552a) to be shared among Department staff for work-related purposes. Disclosure of this information is also subject to all of the published routine uses as identified in the Privacy Act System of Records Notice COMMERCE/DEPT-23, Information Collected Electronically in Connection with Department of Commerce Activities, Events, and Programs.
Disclosure: Furnishing this information is voluntary; however, failure to provide some or all of this information may remove the individual from consideration to be a reviewer for the Young Changemakers Fellowship.
Public Burden Statement
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork Reduction Act of 1995 unless the information collection has a currently valid OMB Control Number. The approved OMB Control Number for this information collection is 0690-0038. Without this approval, we could not conduct this information collection. Public reporting for this information collection is estimated to be approximately 6 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information collection. All responses to this information collection are voluntary. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to Lauren Gibson at lauren.gibson@noaa.gov.
REVIEWER SIGN-UP FORM:
Young Changemakers Fellowship
Thank you for your interest in being a reviewer for applications for the Young Changemakers Fellowship class of 2024-2025! We genuinely appreciate your time and willingness to help us select an outstanding group of young people to participate in this program.
Reviewers will be asked to review between 5-10 applications, depending on reviewer numbers and interest. We estimate that it will take about 30 minutes to do a proper review of an application.
We will send all reviewers their application assignments by June 17 and ask that you complete your reviews by June 24. Reviewers will receive a rubric by which to assess all applications and a Google Form (or Excel sheet, if preferred) to submit application scores.
Please note: If you have applied for or written a letter of recommendation for the Young Changemakers Fellowship class of 2024-2025, you are disqualified from being a reviewer.
Please fill out this form to express your interest in reviewing applications by June 14. If you have any questions, please reach out to young.changemakers@noaa.gov.
Basic Information
* Indicates required question
Email*
First Name
Last Name
What is your current affiliation / organization?*
What is your job title?*
Optional Personal Information
The below questions ask you about your personal identity and are optional to complete. We greatly appreciate any information you are comfortable providing, as it helps ensure that we have a diversity of perspectives reviewing our applications — and ultimately helps us to build a strong, diverse class of Young Changemakers.
If you prefer not to provide this information, please skip this section.
How often do you interact with young people (under the age of 25)?
Sliding scale (from 0 indicating “never” to 10 indicating “daily”)
What is your current geographic region (based on Sea Grant Program locations, if you are in a state not serviced by a Sea Grant Program, please chose other)
West (California, Nevada)
Southwest (Utah, Colorado, Arizona, New Mexico)
South (Texas, Oklahoma, Kansas, Arkansas, Mississippi, Louisiana)
Southeast (Florida, Alabama, Georgia, South Carolina, North Carolina, Virginia)
Northeast (Maryland, Delaware, New Jersey Pennsylvania, New York, Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine)
Central (West Virginia, Kentucky, Tennessee, Missouri, Illinois, Indiana, Ohio)
Upper Midwest (Minnesota, Iowa, Wisconsin, Michigan)
Northern Rockies and Plains (Montana, North Dakota, South Dakota, Nebraska, Wyoming)
Northwest (Washington, Oregon, Idaho)
Islands (Hawaii, American Samoa, Guam, U.S. Virgin Islands, Puerto Rico, Northern Marianas Islands)
Alaska
Washington, DC
Outside of the United States
Prefer not to answer
Other:
Degrees completed (check all the apply)
High School
Associates
Professional Certificate
Bachelors (Arts or Science)
Masters
Doctorate
JD
Prefer not to answer
Other:
To which career stage do you most relate? (Check all the apply)
Student (enrolled at any degree level)
Early Career (0-10 years after completion of last degree)
Mid Career
Senior/Leadership position
Retired
Prefer not to answer
Other:
In what employment sector do you currently work? (check all the apply)
Federal Employee/Contractor
Academic (professor/researcher/student/etc.)
Education/Outreach/Extension
Consulting
Law/Policy
Prefer not to answer
Other:
Do you identify with any of the following groups that the federal government, in Executive Order 13985, identified as underserved? Check all that apply.
Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders, and other persons of color
Members of religious minorities
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons
Persons with disabilities
Persons who live in rural areas
Persons otherwise adversely affected by persistent poverty or inequality
No, I do not identify with any of these groups
Commitment Abilities
Ideally, we ask that everyone review up to 10 applications, with an estimated review time of 30 minutes per application. However, we understand folks are busy. Please take this time to let us know how many applications you can commit to. We will do our best to accommodate these requests.
Please indicate your commitment level.
3-5 applications
6-8 applications
8-10 applications
I can take more than 10 applications!
Thank you!
Please let us know if you have any questions and we will do our best to follow up with you directly! [blank space for questions / comments]
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Adrienne.Thomas |
File Modified | 0000-00-00 |
File Created | 2024-07-20 |