Panelist - Community Peer Panel Application
Statewide Community Regrant Program
Full Name
*
First Name
Last Name
County of Residence
*
Please Select
Columbia
Greene
Schoharie
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
Why are you interested in becoming a panelist?
*
Please describe your experience around the arts as a community member within your county.
*
Share a short bio that includes your professional experience, creative practice, and if you'd like to share about your personal background.
*
Upload resume (optional)
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