1.Please enter your contact information:

First Name

Last Name

Your Title or Position

Your Email Address

Name of Your Institution 

Institution Location (City, State)

2.Which of the following best describes your institution? (check all that apply)

2 Year College

4 Year Public College or University

4 Year Private College or University

Minority Serving Institution

For profit organization or corporation

Non or not for profit organization or corporation

Professional Association

Informal STEM Institution (e.g., science center, zoo)

3.If Minority Serving Institution is selected, please select the type below:

Hispanic Serving Institution (HSI)

Historically Black College or University (HBCU)

Tribal College or University (TCU)

N/A

Other (please specify)

4.Your Highest Degree Obtained

PhD. Or EdD

Specialist Degree

M.S., M.A. or MEd

B.S. or B.A.

High School Diploma

Other: ______

5.Major or Primary Discipline(s) for B.S. or B.A. degree (if applicable)

6.Major or Primary Discipline(s) for M.S., M.A., or MEd degree (if applicable)

7.Major or Primary Discipline(s) for PhD or EdD degree (if applicable)

8.Areas of Expertise

9.Are you interested in serving as a proposal reviewer for the Division of Graduate Education?

No

Yes

10.If Yes, for which programs would you like to serve as a proposal reviewer (check all that apply):

Accelerating Discovery: Educating the Future STEM Workforce (AD)

CyberCorps(R) Scholarship for Service (SFS)

EHR Core Research (ECR): Building Capacity in STEM Education Research (ECR: BCSER)

EHR Core Research: Production Engineering Education and Research (ECR)

Graduate Research Fellowship Program (GRFP)

Graduate Research Internship Program (GRIP)

Innovations in Graduate Education (IGE) Program

National Science Foundation Research Traineeship (NRT) Program

Secure and Trustworthy Cyberspace (SaTC)

Secure and Trustworthy Cyberspace Frontiers (SaTC Frontiers)

Training-based Workforce Development for Advanced Cyber infrastructure (Cyber Training)

11.Are you interested in serving as a proposal reviewer for the Division of Undergraduate Education?

No

Yes

12.If Yes, for which programs would you like to serve as a proposal reviewer (check all that apply):

Advanced Technological Education (ATE)

Improving Undergraduate STEM Education: Education and Human Resources (IUSE: EHR)

Scholarships in Science, Technology, Engineering, and Mathematics (S-STEM)

Robert Noyce Teacher Scholarship Program

13.Are you interested in serving as a proposal reviewer for the Division of Research on Learning in Formal and Informal Settings (preK-12, Informal)?

No

Yes

14.If Yes, for which programs would you like to serve as a proposal reviewer (check all that apply):

Advancing Informal STEM Learning (AISL)

Computer Science for All (CSforAll: Research and RPPs)

Discovery Research PreK-12 (DRK-12)

EHR Core Research (ECR): Building Capacity in STEM Education Research (ECR: BCSER)

EHR Core Research: Production Engineering Education and Research (ECR)

Innovative Technology Experiences for Students and Teachers (ITEST)

Smart and Connected Communities (S&CC)

15.Are you interested in serving as a proposal reviewer for the Division of Human Resource Development?

No

Yes

16.If Yes, for which programs would you like to serve as a proposal reviewer (check all that apply):

ADVANCE: Organizational Change for Gender Equity in STEM Academic Professions (ADVANCE)N NSF-wide

Alliances for Graduate Education and the Professoriate (AGEP)

Centers of Research Excellence in Science and Technology (CREST) and HBCU Research Infrastructure for Science and Engineering (RISE)

EHR Core Research (ECR): Building Capacity in STEM Education Research (ECR: BCSER)

EHR Core Research: Production Engineering Education and Research (ECR)

Historically Black Colleges and Universities Undergraduate Program (HBCU-UP)

Improving Undergraduate STEM Education: Hispanic-Serving Institutions (HSI Program)

Louis Stokes Alliances for Minority Participation

Presidential Awards for Excellence in Science, Mathematics and Engineering Mentoring (PAESMEM)

17.Are you interested in serving as a proposal reviewer for other EHR or Foundation-Wide programs or initiative?

No

Yes

18.If Yes, for which programs would you like to serve as a proposal reviewer (check all that apply):

NSF INCLUDES (Inclusion across the Nation of Communities of Learners of Underrepresented Discoverers in Engineering and Science)

CAREER

Other (please specify)