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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.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Position
*
Undergraduate Student
Graduate Student
Post-doc
Faculty
Scientific Staff
Visitor
Other:
JINA-CEE (associated) institution where you are working/visiting
*
Your answer
Country
*
Your answer
Research Focus
*
MA1: Understanding the Rise of the Elements
MA2: Understanding Dense Neutron-rich Matter
Both
For students and postdocs: Faculty member you are working with (advisor or supervisor)
Your answer
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))?
Yes (if "Yes", skip the next question)
No
Other:
Citizenship(s)/residency(ies)
(list all countries currently holding citizenship/permanent residency, and indicate which his most recent)
Your answer
Gender
Your answer
Disabilities
(optional)
Yes
No
Prefer not to answer
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