OPP USAP Media Visits Application

National Science Foundation Polar Media Program Application for the Arctic and the U.S. Antarctic Program

First name: (text field)
Last name: (text field)
Occupation: (text field)
Organization: (text field)
Organization website URL: (text field)
Website reach: (text field):
Email address: (text field)
Mailing address: (text field)
Phone number: (text field)

How did you hear about the NSF Polar Media Program: (text area, max 250 characters)

Social media

Do you have a social media presence? Please provide the URL and number of followers for each.
YouTube: (text field) Number of followers: (text field)
Facebook: (text field) Number of followers: (text field)
Twitter: (text field) Number of followers: (text field)
Other: (text field) Number of followers: (text field)

Joint application information

If this application is submitted on behalf of a group, please list the other group members' information. It is preferred that a proposal not require more than two or three participants.

First name: (text field)
Last name: (text field)
Occupation: (text field)
Organization: (text field)
Email address: (text field)
Mailing address: (text field)
Phone number: (text field)

First name: (text field)
Last name: (text field)
Occupation: (text field)
Organization: (text field)
Email address: (text field)
Mailing address: (text field)
Phone number: (text field)

Travel information

Are you interested in traveling to the Arctic or Antarctica: (radio buttons, select either one or the other)

How many people need to travel to complete your proposal? It is preferred that a proposal not require more than two or three participants:

Have you traveled to the Arctic or Antarctica before? Please provide details: (text area, max 250 characters)

Proposal information

Principal medium (TV, film, radio, online, etc.):

Please describe your proposal in 50 words or fewer: (text area)

Please provide a detailed description of your proposal, including key objectives, in 500 words or fewer: (text area – limit 500 words)

Please detail the planned timeline for your proposal, including advance research, interviews and delivery of proposed output, in 250 words or fewer: (text area – limit 250 words)

Selection criteria

Describe how your proposal will provide a greater understanding of Arctic or Antarctic science or the region itself in 350 words or fewer:
(text area, limit 350 words)

Provide an outreach plan elaborating on how the proposal will be distributed and promoted to maximize outreach. Outline primary, secondary and other mediums by which you will do this in 250 words or fewer:
(text area, limit 250 words)

Identify the reach you expect your product/proposal to have and how you arrived at this number in 250 words or fewer:
(text area, limit 250 words)

Identify the equipment and facilities required to complete the proposal (i.e., tents, field or dive equipment, transportation, sea ice) in 250 words or fewer. If you intend to transport technical or filming equipment and other resources to Antarctica, please list these, including their estimated weight:
(text area, limit 250 words)

Would you and/or your organization be prepared to allow NSF to use any of your media materials with agreed attributions? Please answer yes or no: (radio buttons, select only one or the other)

Confirmation

I understand that submission of this application does not guarantee that it will be approved, which is solely within NSF's discretion.

Furthermore, I understand that the impacts of COVID-19 may result in NSF reducing the capacity of the NSF Polar Media Program in the Arctic or Antarctic and that budgetary, staffing and/or other circumstances or considerations may limit NSF's ability to accommodate such media travel requests.

Furthermore, by submitting this application, I hereby represent that, if approved, I (and/or the individuals or entities on whose behalf I am submitting this application) intend to go to the Arctic or Antarctica this season. If such intent changes at any time after I submit this application, I will immediately notify NSF so it can consider whether to offer the opportunity to another applicant.

I understand that if my application to travel with the NSF Polar Media Program is approved, I will be required to complete a full medical examination.

I am aware that no financial assistance or funding for completion and distribution of the proposal will be provided by NSF.

All insurance to cover for loss of personal property shall be the responsibility of the traveler, and NSF shall neither insure nor indemnify the traveler or any other party for any such loss.

PRIVACY ACT STATEMENT

NSF is collecting the information requested by this application form under the authority of the "NSF Act of 1950," as amended, for purposes of processing and managing requests by individuals and entities for approval to travel to the Artic or Antarctic as part of NSF's Polar Media Program. The information may be routinely used by authorized NSF personnel or contractors in administering the NSF Polar Media Program and as otherwise described in the system notice published for the applicable NSF system of records. See NSF-12, “Fellowships and Other Awards”. In addition, the information may be disclosed to the extent required by the Freedom of Information Act, or as may otherwise be permitted under the "Privacy Act of 1974." While this application form is voluntary, NSF may decline to consider your application unless you provide all requested information. If your information is incomplete or unclear, NSF may ask you to submit additional information in support of this application form, under the same authority and for the same purposes and routine uses described in this statement.

An agency may not conduct or sponsor, and a person is not required to respond to, an information collection unless it displays a valid OMB control number. The OMB control number for this collection is 3145-XXXX. Public reporting burden for this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions. Send comments regarding the burden estimate and any other aspect of this collection of information, including suggestions for reducing this burden, to:

Reports Clearance Officer

Policy Office, Division of Institution and Award Support

Office of Budget, Finance, and Award Management

National Science Foundation Alexandria, VA 22314

I have read and acknowledge the confirmation information. <Include a check box and ‘Submit application’ button>

(Confirmation language once the application has been submitted (show in a new window)

"Thank you for submitting your application to the NSF Polar Media Program. Your application will be reviewed and if selected, you will be contacted by a member of the NSF Polar Media Program Committee for further discussion."