FINAL Expression of Interest Template

Federal Emergency Management Agency

Building Resilient Infrastructure and Communities (BRIC)

FY 20 National Competition Panel Review

Expression of Interest Form

Instructions: Please complete this form to volunteer to participate (representing a local, Tribal, Territorial, State, or Federal government agency) as panelist for the FY 2020 BRIC Grant Program Qualitative Evaluation Criteria for the National Competition.

1. Name:

2. Work Address, City, State, Zip:

3. Work Email:

4. Work Phone Number:

5. Job Title:

6. Organization:

7. What type of government organization do you work at:

   1. Local

   2. State

   3. Tribal

   4. Territory

   5. Federal

   6. Other ________

8. Indicate your individual level of experience (in number of years) working with HMA. (Select one)

   1. 0-2 years of experience

   2. 3-5 years of experience

   3. 6-9 years of experience

   4. 10+ years of experience

9. Please tell us why you are a good candidate to serve as a national competition panelist for BRIC:

10. Do you have experience with the following hazard mitigation (select all that apply)

    1. Seismic

    2. Flood

    3. Wildfire

    4. Wind/hurricane

    5. Drought

    6. Winter storm

    7. Nature based solutions

    8. Other _________

11. What weeks are you available to virtually attend (Dates are subject to change)*:

    1. March 1-5

    2. March 8-12

    3. March 15-19

    4. March 22-26

    5. March 29- April 2