ICP Member Background Information

 

Dear ICP member,

As an ICP member, you are requested to complete the list of background information items below so that we may update and further build our membership database.

Thank you for your cooperation.

* 1. Last Name (Family Name)

* 2. First Name

* 3. Middle Name

* 4. Title

* 5. Current Work Address

* 6. City

* 7. State

* 8. Zip Code

* 9. Country

* 10. Telephone (Country Code)

* 11. Home Telephone Number

* 12. Office Telephone Number

* 13. Cellphone Number

* 14. Email Address

* 15. Highest Academic Degree Obtained

* 16. Institution from which Highest Degree was obtained

* 17. Year in which Highest Degree was obtained

* 18. City in which Highest Degree was obtained

* 19. State in which Highest Degree was obtained

* 20. Country in which Highest Degree was obtained

* 21. Other Degrees (when, where)

* 22. Year of ICP Membership

* 23. ICP Elected and Appointed Roles

* 24. Languages You Speak

* 25. List Your Academic Specializations

* 26. List Your Research Interests

* 27. List Your Specialist Areas/Skills

* 28. List Selected Publications

* 29. List Conventions Attended

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Thank you for participating in this short survey. This will help ICP update its membership database.

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