NSHE Sponsored Programs Office/EPSCoR Participant Information
You have been asked to provide the following information because you are a recipient or participant of a federal program. Please answer the following questions about yourself, your institution and your position. We need this information for reporting to our funding agencies. Thank you.
 
1.
Contact information.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com

2.
Position.
Faculty
Technical Support Staff
Non Technical Support
Post Docs
Graduate Student
Undergraduate Student
K-12 Student and/or Teacher
Other  
3.
Gender.
Male
Female
Prefer not to respond.
4.
Ethnicity.
Hispanic
Non Hispanic
Prefer not to respond.
5.
Race. (Check all that apply.) 

Race definition: American Indian or Alaska Native: a person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.

Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Phillippine Islands, Thailand and Vietnam.

Black or African American: A person having origins in any of the black racial groups of Africa.

Native Hawaiian or other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White: A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Prefer not to respond.
6.
What is your citizen status?
US Citizen
Permanent Resident
Prefer not to respond.
Other  
7.
Disability Status. (Check all that apply.)
Hearing Impairment
Visual Impairment
Mobility Impairment
None
Prefer not to respond.
Other  
8.
What is the name of the organization with which you are affiliated?
 

  • 50 character(s) left.
9.
Is your organization classified by the US government as one of the following? (Generally applies to academic institutions.)
Historically Black College or University (HBCU)
Hispanic Serving Institution (HSI)
Tribal College or University (TCU)
No
10.
Which of the following best describes your organization?
Academic Institution - PhD Granting
Academic Institution - Non PhD Granting
National Lab
Industry
Federal Agency
State Agency
Other  
11.
What is your position in the above organization?
Adjunct Faculty
Administrator
Assistant Prof
Associate Prof
Full Professor
Graduate Student
Post Doc
Research Professor
Staff-Professional/Te-
chnical
Undergraduate Student
Visiting Professor
Other  
12.
Which of the following NevadaNSF EPSCoR Climate Change components are you most involved in?
NSF Climate Change - Climate Modeling
NSF Climate Change - Cyberinfrastructure
NSF Climate Change - Ecology
NSF Climate Change - Education and Outreach
NSF Climate Change - Water Resources
NSF Climate Change - Policy and Decision Making
13.
Federal agency for this reporting. (Please check all that apply.)
Department of Energy EPSCoR
National Aeronautical and Space Administration EPSCoR
National Science Foundation EPSCoR - Climate Change
Nevada NASA Space Grant Consortium
College Access Challenge Grant Program - GoToCollegeNevada.org
Thank you for your participation in Nevada System of Higher Education programs.  

"Achieving Success for Nevada's Researchers, Educators and Students"