IASSIST Fellows Application Form 2012
<center> <small> 38th Annual conference </small>
<bold>Data Science for a Connected World: Unlocking and Harnessing the Power of Information</bold>
http://www.iassist2012.org/index.html

<small> Washington, DC, United States, June 4 - 8, 2012 </small>

Please take care to respond to each question.
Incomplete applications cannot be processed.
</center>
Name *
As it appears on your passport
Your answer
Your preferred name
What would you like to be called?
Your answer
Professional Email Address *
Your answer
Preferred Email Address
Your answer
From which major city will you be traveling to attend this conference?
If the city is in a country that is different from your citizenship, please tell us which country your passport is issued from.
Your answer
Who is your employer? or if you are a student, which graduate program have you attended? *
Please list some of your clients or your intent if you are self employed.
Your answer
What is your employer's website address? of if you are a student, what is the website of the program you have attended? *
Indicate if none. Please also feel free to add additional relevant URLs that support your claim as a data-professional, and thus, your interest in attending IASSIST '12.
Your answer
What is your job title? and/or what is your degree? *
Your answer
Please provide a short description of what your work entails. In what ways to do you manage or use data? *
We are interested in making sure that the IASSIST conference is a good match with your skills, your job and/or your aspirations!!
Your answer
If applicable, please tell us your work or school supervisor's name and title.
They will not be contacted without your permission.
Your answer
What is it about IASSIST that interests you? What do you expect to gain from attending the conference? *
Your answer
Have you submitted a paper for this conference?
If so, please list the title.
Your answer
How did you hear about IASSIST? *
Have you attended any other IASSIST conferences?
Your answer
Would you like to tell us anything else about your reasons for wishing to attend this IASSIST conference?
Your answer
Do you need assistance with acquiring a US visa?
Based on the evidence shared here, we can help by providing a supporting letter to take to the consulate.
What happens next:
IASSIST is an organization entirely managed and run by volunteers from among its membership. Membership and conference fees are low and this is our only source of funding in support of the IASSIST Fellows program. If you have additional funding sources, we are happy to coordinate with you and thus, provide for more participation.

The committee of volunteer members will take all the applications and work to determine our best allocation of our budgeted funds.

Luis Martínez-Uribe (committee chair) will be in touch with updates as soon as possible. He may also introduce you to a committee member who is closer to you either geographically or in the kind of work that you do.

Applications will be accepted until February 29, 2012 but most people will need to begin as soon as possible on acquiring an appropriate US visa.

We wish you all the best!
~ The committee in support of the IASSIST Fellows Program
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