Evaluation Review Panel – Reviewer Availability Evaluation Review Panel REVIEWER AVAILABILITY FORM Evaluation Review Panel Availability - June 2021 First Name*Last Name*Credentials*Governing Organization/Employer*Nursing Education Unit/Department*Work State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificHome State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificACEN-Accredited Nursing Programs*Which nursing program type(s) is/are ACEN-accredited at your governing organization? (check all that apply) Practical Diploma Associate Baccalaureate Master's Clinical Doctorate Not Applicable (Clinicians) Nursing Program Experience*Which nursing program types are do you have experience in, in the past 5 years? (check all that apply) Practical Diploma Associate Baccalaureate Master's Clinical Doctorate Evaluation Review Panel Experience*How many Evaluation Review Panels have you previously served on?01 - 23 - 45+Availability*On which days will you be available to serve as an ERP Program Reviewer? (check all that apply) A panel assignment may consist of 1-2 days. Tentative time of day is 9:00 AM - 4:00 PM Eastern Time Exact schedule will be confirmed at a later date. Wednesday, June 2, 2021 (For Focused Visits) Monday, June 7, 2021 Tuesday, June 8, 2021 Wednesday, June 9, 2021 Thursday, June 10, 2021 Not Available Comments/Notes Please submit by Monday, January 4, 2021