Form NSF 428A NSF 428A Proposal Reviewer Form

National Science Foundation
REVIEWER BACKGROUND INFORMATION
DATE _________________
1. NAME (TITLE, FIRST, M.I., LAST) ________________________________________________________________________________________
(Enter your name as it should appear on a mailing label.)
2. ACADEMIC RANK or POSITION) ______________________________________________________________________________________
3. ADMINISTRATIVE TITLE (if any) _______________________________________________________________________________________
4. DEPARTMENT, SECTION, or OTHER UNIT ______________________________________________________________________________
5. INSTITUTION or ORGANIZATION ____________________________________________________________________________________
6. STREET ADDRESS _________________________________________________________________________________________________
7. CITY, STATE, ZIP __________________________________________________________________________________________________
8. PHONE and FAX:

Office phone (____) ____-________

Home phone (____) ____-________

Fax (____) ____-________

9. EMAIL ___________________________________________________________________________________________________________
10. GENDER

Male

Female

11. ETHNICITY

Hispanic or Latino

Not Hispanic or Latino

12. RACE (check one or more)

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

Asian

White

Black or African American
13. DISABILITY STATUS (check one or more)

Hearing Impairment

Other

Visual Impairment

None

Mobility/Orthopedic Impairment
14. TYPE OF EMPLOYING INSTITUTION

Public University/College
If University/College, indicate the highest
degree awarded by that institution:

Private University/College
Business/Industry
Government Agency
K-12 School or School System

Associate

Master’s

Baccalaureate

Doctorate

If K-12 School, indicate grade level(s):

Other
15. EDUCATION

Institution

Discipline

Year of Degree

B.S. (or equiv.)

___________________________________

_____________________________

____________

M.S. (or equiv.)

___________________________________

_____________________________

____________

Ph. D. (or equiv.)

___________________________________

_____________________________

____________

Postdoctoral

___________________________________

_____________________________

____________

16. AREAS OF EXPERTISE OR SPECIAL INTEREST ________________________________________________________________________
______________________________________________________________________________________________________________
17. MOST RECENT PANEL REVIEW AT NSF (if applicable):

Program _________________________________ Month/Year ___________

Please return this completed form with your résumé or curriculum vitae to:

NSF Form 428A (03/2008)

NATIONAL SCIENCE FOUNDATION
4201 WILSON BLVD., SUITE 835
ARLINGTON, VA 22230
OMB No. 3145-0058
Expires 10/2021

Message to Prospective Reviewers for the
DIVISION OF UNDERGRADUATE EDUCATION*

The National Science Foundation’s Division of Undergraduate Education (DUE) manages several grant
programs that support improvement in the quality of undergraduate education. The NSF staff relies heavily on
the judgment of the reviewers in evaluating proposals submitted to these highly competitive programs.
Verbatim but anonymous copies of reviews, ratings, and associated correspondence are sent to the Principal
Investigator/Project Director. Subject to this NSF policy and applicable laws, including the Freedom of
Information Act (5 USC §552), the identity of reviewers is given maximum protection from disclosure. In
addition to providing valuable input to NSF, reviewers report that they professionally benefit from serving on
panels.
Reviewers are selected primarily on the basis of discipline and specialty. DUE also selects reviewers to
represent various types of institutions and organizations, geographical areas, and populations. Serving on a
panel involves participating in a meeting held in the Washington, D.C., area for one to three days to read and
discuss proposals and write reviews. NSF directly purchases panelists’ airline tickets and provides panelists
compensation to cover hotel and meal expenses.
DUE seeks to maintain a pool of potential reviewers. Persons who send in the Reviewer Background
Information form and a current curriculum vitae may not be invited to review immediately, but this
information is retained for future reference in selecting reviewers.
The information requested on the Reviewer Background Information form is pursuant to the National Science
Foundation Act of 1950, as amended. Disclosure of all information is entirely voluntary. The purpose of this
background information is to assist in the identification of prospective panelists to review proposals or provide
guidance to NSF staff in connection with the administration of NSF science education support programs.
Other NSF programs requesting names of potential reviewers or specialists in particular fields may also be
given information from this form. Except for these purposes, this information will not be disclosed except as
part of statistical reports or in a form that would not allow identification of individuals.

NSF Form 428A (03/2008)

OMB No. 3145-0058
Expires 05/2011