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JINA-CEE Participant Form
JINA-CEE must report to NSF all individual engaged with its goals and work.
This form helps JINA-CEE track all participants.
First Name
Your answer
Last Name
Your answer
Title
Your answer
Email Address
Your answer
Local Addresss
Your answer
Local Phone
Your answer
Home Institution Address
Your answer
Home Institution Phone
Your answer
JINA-CEE location where you are working/visiting
Research Focus
Faculty member you are working with (advisor or supervisor)
Your answer
I receive the following JINA-CEE Support
Demographics
The following information is used in reporting to NSF, but will remain confidential.
Citizenship
Are you a US Person (any individual who is a citizen of the United States, a permanent resident alien of the United States, or a protected individual as defined by 8 U.S.C. 1324b(a)(3)?
Citizenship(s)/residency(ies)
(list all countries currently holding citizenship/permanent residency, and indicate which his most recent)
Your answer
Gender
Type of Participant
Disabilities
(optional)
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