Form 0920-1050 2020 Science Ambassador Application Survey

Form Approved

OMB No. 0920-1050
Expiration Date: 05/31/2022

Attachment 1: 2020 Science Ambassador Application Survey

[Page 1. Introduction]

The information you provide will be used to guide the direction of future design of Science Ambassador Applications. Your participation is voluntary.

You may take this survey anonymously. Information will be treated in a secure manner.

This survey will take approximately 10 minutes to complete. By continuing to the next page, you have consented to complete this survey. Please contact [email protected] if you have any questions or problems concerning this survey.

The public reporting burden of this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to - CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333 ATTN: PRA (0920-1050).

[Page 1. General Information]

1. Did you finish/submit your application for the 2020 Science Ambassador Fellowship? (select one)*

   • Yes (skip to page 3)

   • No

[Page 2.]

2. Which of the following best describes why you decided not to finish/submit your Science Ambassador Fellowship application? (select one)*

   • I do not meet the eligibility requirements

   • I have decided to attend a Science Ambassador regional training instead

   • I have decided to pursue other opportunities

   • I am no longer available for 1-week course in July

   • The application period was too early in the calendar year

   • The application period was too short

   • I was not able to request and receive letters of recommendation before the deadline

   • The online application was difficult to navigate and/or submit materials

   • The online application was too long/took too much time to complete

   • I do not have support from my school to participate in the opportunity

   • I do not have funding to participate in this opportunity

   • Other (Please specify):_________________

[Page 3. Application Issues]

3. Did you encounter any issues while filling out your application? (select one)*

• Yes

• No (skip to page 5)

[Page 4. Application Issues]

4. What issue(s) did you face while filling out your application? (Select all that apply)*

   • The online application was too long/took too much time to complete

   • The online application was difficult to navigate

   • My letter of recommendation request writer did not receive an e-mail about the request

   • My letter of recommendation writer was not able to upload their letter

• The instructions to complete the application were not clear

• Other (please specify):______________________

5. Did you submit a help desk ticket at any time or contact [email protected]? (select one)*

• Yes

• No

6. Please provide any additional information about the issue(s) you encountered while completing your application (Open-ended):

[Page 5. Overall Feedback]

7. Are you currently a US citizen?*

• Yes

• No

8. Are you planning to apply to the Science Ambassador Fellowship in the future?* (Check all that apply)

   • Yes

   • No (describe why not)

9. Please provide any additional information you would like the Science Ambassador Team to know (Open-ended)

[Page 6. Thank you]

Thank you for taking the time to complete this survey. We will use this information to make improvements to our services. If you have questions or concerns, please contact us at [email protected].