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BTI Alumni Questionnaire

Please be sure to click "Submit" so BTI may access your response

Your Preferred Contact Information

Question Title

* 1. Name

Title

First Name

Middle Initial

Last Name

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* 2. Address

Mailing Address

Mailing Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

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* 3. This is my:

Home Address

Work Address

Temporary Address

Other (please specify)

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* 4. Would you like your name, email, and affiliation to be included in the BTI Alumni Directory?

Yes, opt-in

No, opt-out

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* 5. Please confirm BTI Lab/Department and dates.

Alumni Networking

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* 6. Please help us develop a strong Alumni Network by identifying which of the following would interest you.

Information about alumni posted on the BTI website

Alumni networking (i.e. LinkedIn Alumni Group, Listserv)

Alumni highlights in monthly LabNotes e-newsletter

Periodic alumni dinners or other events

Other (please specify)

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* 7. If interested, how far would you be willing to travel to attend an alumni event?

Less than one hour

1 - 3 hours

Within a specific region - Please specify that region in the comment box below, (for example: "East Coast," "San Francisco Bay Area," or "New York City")

Comment

Educational and Career Information
We look forward to receiving updates from our Alumni so we may highlight them in our communications. Please include any information that you wish to share below.

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* 8. Please provide links to any professional profiles.

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* 9. Are you currently working in a science-related area? (Please select the statement that best relates to you.)

I am working as a researcher or science educator in the academic sector

I am working as a researcher in the non-profit sector

I am working as a researcher in industry/private sector

I am working in a science-related area in a position other than research

I have retired from a science-related field

I am actively seeking employment in a science related career

I did not pursue a science-related career

Other (please specify)

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* 10. What is your current position description/employer and job title?

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* 11. Please list any awards that you have received.

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* 12. Describe any additional positions/affiliations that you have held and wish to be associated with.

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* 13. The best way to stay informed about BTI news and updates is through our concise monthly newsletter, BTI LabNotes.
You will be added to our Labnotes mailing list unless you opt-out by checking the box below.

Please select this box if you do not want to receive this newsletter.

Question Title

* 14. Did we miss anything? Please use this box to describe anything else you would like to share regarding your educational, professional, or BTI experience.

Thank you for your time and interest in a continued relationship with BTI. Please feel free to contact us at BTIAlumni@cornell.edu for any additional information. You may also send your professional CV to this address.

Wishing you all the best,

The BTI Alumni Relations Team

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* 1. Name

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* 2. Address

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* 3. This is my:

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* 4. Would you like your name, email, and affiliation to be included in the BTI Alumni Directory?

Question Title

* 5. Please confirm BTI Lab/Department and dates.

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* 6. Please help us develop a strong Alumni Network by identifying which of the following would interest you.

Question Title

* 7. If interested, how far would you be willing to travel to attend an alumni event?

Question Title

* 8. Please provide links to any professional profiles.

Question Title

* 9. Are you currently working in a science-related area? (Please select the statement that best relates to you.)

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* 10. What is your current position description/employer and job title?

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* 11. Please list any awards that you have received.

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* 12. Describe any additional positions/affiliations that you have held and wish to be associated with.

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* 13. The best way to stay informed about BTI news and updates is through our concise monthly newsletter, BTI LabNotes.You will be added to our Labnotes mailing list unless you opt-out by checking the box below.

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* 14. Did we miss anything? Please use this box to describe anything else you would like to share regarding your educational, professional, or BTI experience.

* 13. The best way to stay informed about BTI news and updates is through our concise monthly newsletter, BTI LabNotes.
You will be added to our Labnotes mailing list unless you opt-out by checking the box below.