Attachment: I
Review Panel Statement of Interest
Human Services Grants Program FY2023-27
All individuals interested in participating in the HSGP RFP review panel will complete the statement of interest on the following page. The statement will be reviewed by an ad hoc committee formed by the We Are Santa Monica Fund advisory board.
The We Are Santa Monica Fund is a partnership between community donors, the California Community Foundation, and the City of Santa Monica. The Fund provides grants to local nonprofit organizations to support the local economy, advance equity, improve physical and environmental health, and offer resources and emergency relief.
Review Panel Statement of Interest (DRAFT)
Human Services Grants Program Request for Proposal
Personal Information
Name:
Email: Phone:
Occupation: Employer:
Optional Demographic Information
Race/Ethnicity: Gender:
Age: Sexual Orientation:
Disability Status: Veteran Status:
Professional and Personal Experience
1. Please share any relevant experience, skills, or qualifications in the following areas:
a. Personal and/or professional experience with underserved or marginalized populations (including, but not limited to, people experiencing homelessness, early childhood, youth and families, seniors, and people with disabilities). b. Experience with non-profit operations and management or administrative oversight of social services (including service on non-profit boards, City of Santa Monica boards, commissions, or City Council).
c. Lived experience as a consumer of services (including as a person who is or was formerly homeless; person who has experienced mental illness and/or substance abuse; person who is low-income and/or disabled; person who is or has been enrolled in a Santa Monica social service program).
2. Please describe your interest in participating in the Santa Monica HSGP RFP process as a scorer/rater and your connection to Santa Monica, if any.
3. Please state any potential conflict(s) of interest in your participation with scoring HSGP Proposals for City funding, including if you or a close family relative (wife, husband, registered domestic partner, son, daughter, mother, father, brother, or sister) are affiliated in any way with an organization that may apply.