Thank you for your interest in reviewing for NSF/EHR's Racial Equity in STEM program description.

We are working to ensure that we assemble review panels that are diverse in expertise, demographic, career levels, institutional experience (i.e., academic, business, etc.), NSF experience (i.e., those new to NSF as well as those with NSF experience) and expertise within and outside of STEM education.

Please complete this form with as much detail as you are comfortable sharing. We appreciate your interest.

The information requested on the Reviewer Background Information form is pursuant to the National Science Foundation Act of 1950, as amended. Disclosure of all information is entirely voluntary. The purpose of this background information is to assist in the identification of prospective panelists to review proposals or provide guidance to NSF staff in connection with the administration of NSF science education support programs. Other NSF programs requesting names of potential reviewers or specialists in particular fields may also be given information from this form. Except for these purposes, this information will not be disclosed except as part of statistical reports or in a form that would not allow the identification of individuals. OMB No. 3145-0058 Expires 06/2024

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* 1. Date
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Date

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* 2. Please enter your contact information:
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* 3. Area(s) of Expertise (check one or more):

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* 4. Research Methods Expertise (check one or more):

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* 5. Please describe your expertise/experience related to the Racial Equity in STEM Education program description:

Area(s) of Expertise (Check and answer all that apply)

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* 6. STEM EDUCATION AND LEARNING RESEARCH

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* 7. CHEMISTRY (If applicable, please specify expertise.)

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* 8. COMPUTER AND INFORMATION SCIENCES & ENGINEERING (If applicable, please specify expertise.)

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* 9. ENGINEERING (If applicable, please specify expertise.)

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* 10. GEOSCIENCES (If applicable, please specify expertise.)

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* 11. LIFE SCIENCES (If applicable, please specify expertise.)

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* 12. MATERIALS RESEARCH (If applicable, please specify expertise.)

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* 13. MATHEMATICAL SCIENCES (If applicable, please specify expertise.)

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* 14. PHYSICS & ASTRONOMY (If applicable, please specify expertise.)

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* 15. PSYCHOLOGY (If applicable, please specify expertise.)

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* 16. SOCIAL SCIENCES (If applicable, please specify expertise.)

Current and Past Employment Experiences (Check and answer all that apply)

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* 17. Type of Organization

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* 18. PreK-12 Education

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* 19. Public University/College

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* 20. If Public University/College, indicate the highest degree awarded by that institution:

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* 21. Private University/College

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* 22. If Private University/College, indicate the highest degree awarded by that institution:

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* 23. Other (Please Specify)

Education

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* 24. Bachelor's (Or Equivalent) Information

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* 25. Master's (Or Equivalent) Information

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* 26. Ph.D (Or Equivalent) Information

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* 27. Other (Please Detail)

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* 28. HAVE YOU BEEN AN NSF PI or Co-PI? We are working to ensure that we assemble review panels that are diverse in NSF experience (i.e., those new to NSF as well as those with NSF experience).

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* 29. Do you plan to submit for one of the following target dates as PI, Co-PI or Senior Personnel?

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* 30. If yes, select your submission target date.

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* 31. PLEASE SELECT THE TARGET DATES FOR WHICH YOU ARE AVAILABLE TO SERVE ON A REVIEW PANEL (Note: Reviews typically take place 2-3 months after the target date). Also, if you submit a proposal to the Racial Equity in STEM Education program description, you are not eligible to be a reviewer for proposals submitted to that same target date.

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* 32. MOST RECENT PANEL REVIEW FOR NSF (if applicable):

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* 33. DISABILITY STATUS (check one or more)

Demographic Information

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* 34. Gender:

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* 35. Ethnicity

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* 36. Race:

You have successfully completed the survey. Thank you for your time and for your interest in being a reviewer for the NSF/EHR's Racial Equity in STEM program.  Once we have received all responses, we will make selections based on expertise, availability, and need.  If you are not selected as a reviewer in this cycle, we may reach out to you in the future to gauge your interest and availability at that time.

Thank you!

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