CRRB Application

Community Research Review Board (CRRB) Member Application

The Promise Zone Research Connection (PZRC) is seeking residents to join the Community Research Review Board. Members of the CRRB will meet once a month, for two to three hours at a time, to review research proposals affecting the West Philadelphia Promise Zone community. Reach out to Promise.Zone@phila.gov for any questions about the CRRB, or check out our website at https://www.pzrc.org.
Mission Statement

The mission of the Promise Zone Research Connection is to ensure accountability, community involvement, and data sharing for all research conducted in the Promise Zone, in order to expedite the mobilization of resources for the benefit of the community, as determined by it's residents.

Vision

Our vision is to bridge the gap between researchers and Promise Zone residents and stakeholders resulting in benefits for the community including the prevention of harm, increased quality of life, peace, and prosperity.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
- Gender
- Race
  
  Other
- What neighborhood do you live in?
- How did you hear about the PZRC Community Research Review Board?
- Eligibility
  
  Check and fill out your eligibility for at least one member-category:
- I am a...
- If you are a researcher, please: 1) list your title and your research institution of affiliation, and 2) please tell us how you have demonstrated a commitment to community-engaged research.
- If you are a community stakeholder, please: 1) tell us if you are affiliated with an institution, agency, or business in or adjacent to the Promise Zone; 2) tell us which institution, agency, or business this is and what your role is there; 3)tell us if you live adjacent to the Promise Zone; 4) describe your commitment to the neighborhoods in the Promise Zone
- Availibility
- Upon joining the Community Research Review Board, members will:
  
  1) Participate in a mandatory 5-hour training and orientation session
  
  2) Within six-months of approved membership, provide a copy of the certifcate confirming completion of CITI training course
  
  3) Attend meetings of the CRRB as scheduled (7-10 per year)
  
  4) Review all materials submitted by researchers before the meeting
  
  5) Participate in discussions with fellow CRRB members and researchers
- During which hours are you available for Community Research Review Board meetings?
- Special Areas of Interest or Expertise
- Please describe any skills, professional credentials, community affiliations, or lived experience that would contribute to the diversity of the Community Research Review Board. This could include being a doctor or lawyer, experience working with you or seniors, insight or interest in particular medical conditions or research topics (for example, high blood pressure, gun violence, early childhood development, etc.) Expertise in research is not required.
- Please upload a copy of your most recent resume.
  
  Cancelof
- Agreement and Signature
  
  By signing this application, I understand that the information I provide about myself will be kept confidential. Furthermore, I agree that, should I become an official member of the Community Research Review board, I will keep confidential any comments made during the review process, by either the other Board members or the presenting researchers.
- Name
  
  First NameLast Name
- Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Signature
- Should be Empty:

Community Research Review Board (CRRB) Member Application

Special Areas of Interest or Expertise

Agreement and Signature