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National Science Foundation
ICR 202610-3145-004 · OMB 3145-0058 · Object 174264500.
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| File Type | application/pdf |
|---|---|
| File Title | National Science Foundation |
| Author | nsfuser |
| Last Modified By | Acrobat PDFMaker 8.1 for Word |
| File Modified | 2022-12-15 |
| File Created | 2021-10-27 |
| Conversion State | complete |
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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 (LVHQKRZHU$YHQXH AOH[DQGULD9$ OMB No. 3145-0058 ([SLUHV1025 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