Exit this survey ASA Survey for Students in Science Question Title * 1. If you are interested in more information about the American Scientific Affiliation, please let us know how to get in touch with you. We are partnering with the Emerging Scholars Network to provide Christian mentors. Name: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Question Title * 2. What is your current educational status? high school undergraduate graduate Other (please specify) Question Title * 3. What college or university do you attend? Question Title * 4. What degree are you pursuing? natural science math engineering philosophy religion please specify the precise area or note if it was not a choice above: Question Title * 5. What science/faith topics interest you the most? Question Title * 6. If you are an undergraduate, when is your expected graduation date? If you are not currently an undergrad, please skip. 2011 2012 2013 2014 2015 other year (please specify) Question Title * 7. What do you plan to do in the first 3 years after completing an undergraduate degree? attend graduate school teach work in industry get another degree go to Disney World none of the above! I plan to... Question Title * 8. What are your long term career goals/aspirations? Question Title * 9. What is the biggest challenge you face as a Christian in academia? Question Title * 10. Are you interested in a Christian mentor in your field of study? yes no If yes, please specify what you would hope for in a mentorship relationship: Next