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* 1. Please provide your full name.

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* 2. What is your primary email address?

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* 3. Please enter your current stage of training (PGY level, year of fellowship, year into practice)

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* 4. Please enter your current institution of practice.

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* 5. What residency program did you complete before your neurocritical care fellowship?

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* 6. At what type of institution would you ideally prefer to work? Check all that apply.

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* 7. How likely are you to participate in an NCS Virtual Career Fair?

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* 8. Would you like us to contact you when the NCS Career Center webpage is available?

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* 9. Would you like us to contact you when we have more details on our virtual career session focused on navigating the job search with a Visa?

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* 10. Do you give us permission to share your above responses directly with hiring parties (representatives of specific clinical practices, this excludes recruiters) attending the NCS career fair? If no, all your information will remain confidential.

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* 11. Do you give us permission to share your above responses directly with recruiters (individuals typically contracting with multiple hospitals to help recruit for available positions) attending the NCS career fair? If no, all your information will remain confidential.

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* 12. Please sign below to confirm that all the above information is accurate, and to provide consent for release of information if you answered "yes" to the questions above. To sign please place a / before and after your name (ex /Naomi Niznick/)

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