Center for Tribal Nations Advisory Committee Application Your Name* First Last Your Email Address* Enter Email Confirm Email Your Phone Number*Best Time To Call You*When is the best time for us to reach you via telephone? Please select from the options below.Best Time To Call YouMorningsEarly AfternoonLate AfternoonEarly EveningOrganizationHome AddressPlace of Employment Address* Street Address Unit / Suite Number City State Zip Code Country CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands How do you primarily identify yourself?American IndianAlaska NativeCanadian Inuit, Metis or First NationIndigenous Mexican, Central or South AmericanTribal Affiliation(s) Enrolled Member:Tribal Affiliation(s) Descendant:Please list Enrolled Member Tribal Affiliation(s)Please list Descendant Tribal Affiliation(s)What is your gender identity? (optional)WomanManNon-binaryTwo SpiritPrefer to self describePlease describe your preferred gender identityDo you identify as a person with a disability? (Optional) Yes No Please list any community organizations and/or Tribal Governments that you are affiliated with, and a brief description of your involvement (example: ATNI, NACAC):*OMSI has identified the following attributes and areas of expertise as priorities for representation on the Advisory Committee.Please select up to 3 topic area(s) you feel that you best represent based on your education, professional experience, volunteer activities, or other affiliation. Cultural knowledge and traditions Inter-tribal coordination and government relations Community and public relations Art and design Real estate development and finance Organizational development and fundraising Ecology, restoration, and environmental remediation Sustainability, green building, and resilience Economic development, innovation, and entrepreneurship Housing development and community services Workforce development Education Youth leadership Describe your knowledge and experience with the selected topic area(s):Why are you interested in serving on the Advisory Committee?Are you able to commit to serving on the Advisory Committee from April 2021 – June 2022 (or until the grant work is completed) and regularly attend two meetings per month? Yes No Additional InformationIs there anything else we should take into consideration about your application?Are there any barriers to your participation? Please list any considerations or accommodations that would make it easier for you to participate on this committee. If you would like to receive or submit your application in a different format, please contact: firstname.lastname@example.org.If you serve on the Committee, will your employer compensate you for your time? Yes No If not, would receiving a financial stipend make it easier for you to serve on the Committee? Yes No Please check the box below to indicate that you have read the Committee Charter and Timeline for Committee Recommendations. They can be found here: https://atnitribes.org/center-tribal-nations* I have read the Committee Charter and Timeline for Committee Recommendations.CommentsThis field is for validation purposes and should be left unchanged.