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REU Alumni Information Form


Greetings Old Friends!

I need your help. A few minutes of your time once or twice a year will be very helpful in our effort to keep the MLBS REU program funded. NSF requires that we track your progress closely.
All personal data will be retained by MLBS, some of it reported to the NSF, but otherwise kept completely confidential.

If you know you have completed a field before you can skip it now (i.e. information that does not changed, like "Demographic Information").
You certainly can skip the "Demographic" section if you participated as an REU in 1998 or later.

In any case, at a bare minimum, enter your last name and email address.
These are marked with '*'.

Thank you, very much,
Eric Nagy, enagy_AT_virginia.edu
 
Personal and Contact Information:

Name:
First Middle Last*


Reliable/Permanent (>1 year?) Contact Information:
Address Line 1 Phone
Address Line 2 Email*
City State / Province Zip/Postal Code


Best way to contact you:


I'd like to get more REU Alumni involved in recruiting for the program. If you might (no commitment here) be willing to recruit locally, or elsewhere (all expenses paid of course), please check this box:


Demographic Information:
The National Science Foundation requires that we report these demographic data on each program participant.
You can skip if you have filled this out before (like in your application to the REU program)

Gender   Ethnicity Citizenship



Hispanic or Latino - A person of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race.

Race:
(select one or more)

- 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.
- 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 Philippine Islands, Thailand, and Vietnam.
- A person having origins in any of the black racial groups of Africa.
- 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.

Disability Status:
(select one or more)










Professional History:

Schools?
Program Names or Majors?
Degrees Earned?
Date Degrees Earned or Expected?:


Did you have an NSF Graduate Fellowship?

Please list all employment / career positions held following graduation from your highest degree:


Current Position:


All publications stemming from your MLBS REU project:


All presentations (talks or posters) stemming from your MLBS REU project:




Please Review and Submit Your Data.

Thank you very much!

Note: When you click submit you will receive a confirmation, and then be transferred to our on-line waiver page. JUST IGNORE THIS. We are reconfiguring our web forms and this will be fixed soon. Sorry.



This material is based upon work supported by the National Science Foundation under Grant No. DBI-9300149, DBI-9423983, DBI-9732155, DBI-0097249, and DBI-0453380.

 Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.

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mlbs.org or www.mlbs.virginia.edu - This page last updated:  Friday, 09-Feb-2007 12:38:56 EST