NMNEN 3RD WORKSHOP, ALBUQUERQUE NM AUGUST 2010 Survey

This workshop is jointly sponsored by a CCLI Phase I award (#0633736) from NSF DUE and CINT

Thank you for your interest in NMNEN,

Boris Kiefer, Vicente Lombrana, Elba Serrano

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* 1. NAME

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* 2. POSITION

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* 3. CONTACT EMAIL

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* 4. CONTACT PHONE

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* 5. DEPARTMENT (STUDENTS, IF NOT EMPLOYED, STATE YOUR MAJOR)

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* 6. INSTITUTION

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* 7. MAILING ADDRESS

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* 8. Please select the row and column that best indicate your intended participation.

	I will submit materials for dissemination	I will NOT submit materials for dissemination
I will attend	I will attend I will submit materials for dissemination	I will attend I will NOT submit materials for dissemination
I might attend	I might attend I will submit materials for dissemination	I might attend I will NOT submit materials for dissemination
I will not attend	I will not attend I will submit materials for dissemination	I will not attend I will NOT submit materials for dissemination

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* 9. STATUS:PLEASE SELECT ALL THAT APPLY

I am a community college faculty member

I am a 4 yr/grad institution faculty member

I am a national laboratory researcher

I am an industry researcher

I am a student

I am a K-12 educator

I am a science writer

other

Other (please specify)

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* 10. STUDENT STATUS:PLEASE SELECT ALL THAT APPLY

I am not a student

I am a CC undergraduate student

I am an undergraduate student at a 4 yr/grad institution

I am a graduate (MS) student

I am a graduate (PhD) student

I am a student with status not listed above(specify below)

Other student status (please specify)

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* 11. Please indicate all your degrees

GED

BA/BS

MS/MA/MPH

PhD

other doctorate

none of the above

Other degrees (please specify)

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* 12. Please provide a brief bio (50-150 words) for the program

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* 13. Briefly describe your interest in nano(bio)science education.

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* 14. Briefly describe the materials you will share with other participants.

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* 15. COURSE OFFERINGS: Which COURSES do you offer? Please select all that apply (Students, select n/a if you have not offered a course)

	elementary school students	middle school students	high school students	lower division UG students	upper division UG students	graduate students	online students	faculty	n/a
biology COURSES for	biology COURSES for elementary school students	biology COURSES for middle school students	biology COURSES for high school students	biology COURSES for lower division UG students	biology COURSES for upper division UG students	biology COURSES for graduate students	biology COURSES for online students	biology COURSES for faculty	biology COURSES for n/a
physics COURSES for	physics COURSES for elementary school students	physics COURSES for middle school students	physics COURSES for high school students	physics COURSES for lower division UG students	physics COURSES for upper division UG students	physics COURSES for graduate students	physics COURSES for online students	physics COURSES for faculty	physics COURSES for n/a
nanoscience (no life science emphasis) COURSES for	nanoscience (no life science emphasis) COURSES for elementary school students	nanoscience (no life science emphasis) COURSES for middle school students	nanoscience (no life science emphasis) COURSES for high school students	nanoscience (no life science emphasis) COURSES for lower division UG students	nanoscience (no life science emphasis) COURSES for upper division UG students	nanoscience (no life science emphasis) COURSES for graduate students	nanoscience (no life science emphasis) COURSES for online students	nanoscience (no life science emphasis) COURSES for faculty	nanoscience (no life science emphasis) COURSES for n/a
nano(bio)science COURSES for	nano(bio)science COURSES for elementary school students	nano(bio)science COURSES for middle school students	nano(bio)science COURSES for high school students	nano(bio)science COURSES for lower division UG students	nano(bio)science COURSES for upper division UG students	nano(bio)science COURSES for graduate students	nano(bio)science COURSES for online students	nano(bio)science COURSES for faculty	nano(bio)science COURSES for n/a
research/scientific ethics COURSES for	research/scientific ethics COURSES for elementary school students	research/scientific ethics COURSES for middle school students	research/scientific ethics COURSES for high school students	research/scientific ethics COURSES for lower division UG students	research/scientific ethics COURSES for upper division UG students	research/scientific ethics COURSES for graduate students	research/scientific ethics COURSES for online students	research/scientific ethics COURSES for faculty	research/scientific ethics COURSES for n/a
other STEM courses not listed above	other STEM courses not listed above elementary school students	other STEM courses not listed above middle school students	other STEM courses not listed above high school students	other STEM courses not listed above lower division UG students	other STEM courses not listed above upper division UG students	other STEM courses not listed above graduate students	other STEM courses not listed above online students	other STEM courses not listed above faculty	other STEM courses not listed above n/a

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* 16. BACKGROUND: Which COURSES or WORKSHOPS have you taken in the following areas?

	lower division UG students	upper division UG students	graduate students	online students	faculty	n/a
biology for	biology for lower division UG students	biology for upper division UG students	biology for graduate students	biology for online students	biology for faculty	biology for n/a
physics for	physics for lower division UG students	physics for upper division UG students	physics for graduate students	physics for online students	physics for faculty	physics for n/a
nanoscience (no life science emphasis) for	nanoscience (no life science emphasis) for lower division UG students	nanoscience (no life science emphasis) for upper division UG students	nanoscience (no life science emphasis) for graduate students	nanoscience (no life science emphasis) for online students	nanoscience (no life science emphasis) for faculty	nanoscience (no life science emphasis) for n/a
nano(bio)science for	nano(bio)science for lower division UG students	nano(bio)science for upper division UG students	nano(bio)science for graduate students	nano(bio)science for online students	nano(bio)science for faculty	nano(bio)science for n/a
research/scientific ethics for	research/scientific ethics for lower division UG students	research/scientific ethics for upper division UG students	research/scientific ethics for graduate students	research/scientific ethics for online students	research/scientific ethics for faculty	research/scientific ethics for n/a

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* 17. PLEASE SELECT ALL THAT APPLY

I attended the 2007 Las Cruces NM-NEN workshop

I attended the 2009 Santa Fe NM-NEN workshop

I am an NM-NEN advisory board member

I am a NM-NEN collaborator

I am a PI or co-PI of an NSF CCLI grant

I am a PI or co-PI of a nanoscience education grant

I am a PI or co-PI of a nanoscience research grant

I am a CINT user

I am a member of the CINT User committee

I am a student participant on an NSF CCLI grant

I am a student participant on a nanoscience EDUCATION grant

I am a student participant on a nanoscience RESEARCH grant

I will present my research at the CINT meeting

I might present my research at the CINT meeting

none of the above describe my activities

Other (optional please specify other nanoscience activities)

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* 18. OPTIONAL DEMOGRAPHIC DATA. Select any that apply to you and that you wish to provide to us.

single parent

first generation college GRADUATE (neither parent, no grandparents etc had completed college during the time you completed your BS/BA degree)

English- not first language

foreign national

English - first language

first generation college FACULTY (neither parent, grandparents etc had held faculty positions when you first became a faculty member)

athlete (amateur or professional)

Chinese - first language

female

male

international student

military veteran

artist (amateur or professional)

Spanish - first language

musician (amateur or professional)

list any ethnicities with which you identify

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* 19. If available, Please provide a link to your web page.

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* 20. How did you hear about the workshop? Please select all that apply

NMNEN webpage

CINT webpage

Facebook page

flyer

conversation

invitation from organizers

other (please explain below)

Other

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* 1. NAME

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* 2. POSITION

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* 3. CONTACT EMAIL

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* 4. CONTACT PHONE

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* 5. DEPARTMENT (STUDENTS, IF NOT EMPLOYED, STATE YOUR MAJOR)

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* 6. INSTITUTION

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* 7. MAILING ADDRESS

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* 8. Please select the row and column that best indicate your intended participation.

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* 9. STATUS:PLEASE SELECT ALL THAT APPLY

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* 10. STUDENT STATUS:PLEASE SELECT ALL THAT APPLY

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* 11. Please indicate all your degrees

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* 12. Please provide a brief bio (50-150 words) for the program

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* 13. Briefly describe your interest in nano(bio)science education.

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* 14. Briefly describe the materials you will share with other participants.

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* 15. COURSE OFFERINGS: Which COURSES do you offer? Please select all that apply (Students, select n/a if you have not offered a course)

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* 16. BACKGROUND: Which COURSES or WORKSHOPS have you taken in the following areas?

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* 17. PLEASE SELECT ALL THAT APPLY

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* 18. OPTIONAL DEMOGRAPHIC DATA. Select any that apply to you and that you wish to provide to us.

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* 19. If available, Please provide a link to your web page.

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* 20. How did you hear about the workshop? Please select all that apply

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* 21. How long did it take to complete this form?

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* 22. DATE