Qualtrics Survey | Qualtrics Experience Management

1. What is your name?

First Name

Last Name

2. What is your contact information?

Institution

Department or Unit Name

State

Email Adress

3. In what type of institution or organization do your work? (check all that apply)

Primarily Undergraduate Institution
Private Industry/Corporate
PhD Granting
2-Year Institution
Minority Serving Institution
Non-profit
Institution Primarily Serving Persons with Disabilities
Other (please specify)

4. What is your primary area of expertise? (check all that apply)

STEM Research
STEM Teaching
Traditional Ecological Knowledge
Academic Administration (Centers of Teaching and Learning, Higher Ed, etc.)
Education Research and/or Discipline-Based Education Research
STEM Faculty Development / Instructional Consultant
Industry (including Private/Public Partnerships)
Other (please specify)

5. If you are based at an institution of higher education, what primary experience or expertise do you have in academic administration? Please note that administrative experience is not required (check all that apply)

Department Chair
Dean/Associate Dean/Assistant Dean
Director of Student Services
Director of a Center for Teaching and Learning
Chancellor/President/Provost
Institutional Researcher
Academic Program Director
Center Director
Other (please specify)

6. Which of the following is an area of your expertise? (check all that apply)

Research Support / Grant Administration
Research Facilities and Infrastructure Management
STEM Education (K-12)
STEM Workforce Development
Broadening Participation in STEM
National and Global Partnership Development
Community Engagement and Outreach
Early Career Research Mentoring

8. In which EPSCoR Research Infrastructure Improvement (RII) program of NSF program have you served as a reviewer? (check all that apply)

EPSCoR RII: EPSCoR Collaborations for Optimizing Research Ecosystems (E-CORE)
EPSCoR RII: EPSCoR Research Incubators for STEM Excellence (E-RISE)
EPSCoR RII: EPSCoR Research Fellows (ERF)
EPSCoR RII: Track-1
EPSCoR RII: Focused EPSCoR Collaborations (FEC)
EPSCoR RII: Broadening EPSCoR Communities
I have not served as a reviewer for NSF, including EPSCoR
Other NSF program or NSF EPSCoR RII program (please specify)

9. In which EPSCoR Research Infrastructure Improvement (RII) program of NSF program have you received an award? (check all that apply)

EPSCoR RII: EPSCoR Collaborations of Optimizing Research Ecosystems (E-CORE)
EPSCoR RII: EPSCoR Research Incubators for STEM Excellence (E-RISE)
EPSCoR RII: EPSCoR Research Fellows (ERF)
EPSCoR RII: Track-1
EPSCoR RII: Focused EPSCoR Collaborations (FEC)
EPSCoR RII: Broadening EPSCoR Communities
I have not received an NSF EPSCoR award
I have not received an NFS award
Other NSF Program or NSF EPSCoR funding opportunity (please specify)

10. In which EPSCoR Research Infrastructure Improvement (RII) program are you interested in serving as a reviewer? (check all that apply)

EPSCoR RII: EPSCoR Collaborations for Optimizing Research Ecosystems (E-CORE)
EPSCoR RII: EPSCoR Research Incubators for STEM Excellence (E-RISE)
EPSCoR RII: EPSCoR Research Fellows (ERF)
EPSCoR RII: Focused EPSCoR Collaborations (FEC)

11. Provide a brief paragraph (4-6 sentences), written in 3rd person, describing your expertise as it relates to professional development for early career investigators and your potential service as a reviewer. Please include specific keywords describing your research interests and any information that you think would be related to your panel assignment (e.g., STEM research, faculty mentoring, etc.). Sample paragraphs are provided below as a guide to the types of content that should be included. Please note that your responses should be brief but does not have to be limited to the information described below.

Sample Research Expertise Summary:
Malcolm Doe holds a Ph.D. in Chemistry and has served as a faculty member for eight years. His research interests include Solid-Phase Microextraction and Multidimensional Gas Chromatography. He has managed several NSF-funded projects, including a current EPSCoR RII: E-RISE project. He serves as a mentor for both undergraduate and graduate researchers. Dr. Doe is an active member of the American Chemical Society (ACS) and has delivered numerous presentations and published over 30 journal articles.

Sample Industry Expertise Summary:
Janna Doe holds a B.S. in Engineering and is a registered Professional Fabrication Engineer in Virginia. Her work entails advancing the development of novel materials and technologies for quantum computer research. She serves on the Industry Advisory Board of the College of Engineering at University XYZ, and as such, provides input to the College for fostering faculty research experiences with industry. Ms. Doe is also actively engaged in recruiting undergraduate students for internships and entry-level employment.