2019 Application

Contact InformationFirst Name:

Middle Name:

Last Name:

Prefix:

Suffix:

Primary Contact Phone:

Email Address:

Confirm Email Address:

(Please Note: Your email address is what we use to track your application and participation in the workshop. Be sure to use the same email address in all forms relating to your workshop participation. This email will also be our primary means of communication with you. Please double-check that you have typed it correctly.)

Academic Contact Information
Primary Institutional Affiliation:

Department:

Title:

Address:

City:

Select a State

Zip Code:

Country:

Academic Phone:

Academic Email:

Demographics

We collect the data below for our reports to the National Science Foundation, which funds this project. The following information will be reported only in aggregate.

Citizenship (choose one):

U.S. Citizen
Permanent Resident
Other non-U.S. Citizen

Gender:

Female
Male
I do not self-identify as either male or female
I prefer not to answer

Ethnicity (choose one):

Hispanic or Latino
Not Hispanic or Latino

Race (select one or more boxes):
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

Disability status (select one or more):
Hearing Impairment
Visual Impairment
Mobility/Orthopedic Impairment
Other
If other, specify

None

Number of years of full-time teaching experience:

Number of years teaching at the college level:

Current position:

Discipline:

or Other discipline:

Will you teach next fall at an institution that serves a large number of minority students?:

Yes
No

Which of the following best describes the department or program in which you will teach next fall:

Two year college (Associate is the highest degree)
Private four-year primarily undergraduate (BS or BA is the highest degree)
Public four-year primarily undergraduate (BS or BA is the highest degree)
Masters granting (MS is the highest degree)
Doctoral granting (PhD is the highest degree)

Question SetPlease list three topics of interest that you would like to see addressed during the workshop:

Topic 1

Topic 2

Topic 3

What do you hope to gain from participation in this workshop?

Have you previously participated in a Minority Faculty Development Workshop?

Yes
No

Document Uploads

Resume/CV:

All uploaded files are public unless you are in a private workspace

Title: A descriptive, human readable title.

e.g. 'Student Handout for Sauerkraut Assignment'

Select the file: Make sure it has an appropriate suffix (e.g. .doc) or specify the type in the Optional Fields below

Description: A very brief description of the file.

Show Optional Fields

File Type:

The system will attempt to determine the correct file type based on the name of the file you've selected. Choosing the correct file type here will override that.

File Name:

e.g. 'student_handout'
This will be the name of the downloaded file. By default the system will generate this based on the title you specified and the type of file. If you specify a name here it will over-ride the automatically generated name. This is generally only useful when uploading file of a type not recognized by the system (not in the list of file types above). In that situation choose File Type: Unknown Binary and include the appropriate suffix in the file name here. e.g. myfile.m3z Avoid spaces or special characters in the file names.

Authorship/Reuse

Either:
I am the author (copyright holder) of the contents of this file and people are allowed to reuse it for non-commercial purposes as long as they give me attribution as described by this creative commons license.
Or

Choose a different authorship/reuse options

Who is the original creator/copyright holder of the information in this file?

Provenance/Acknowledgements

A short description of where the material came from. Include names and institutions of authors and contributors as well as acknowledgment of any work from which this was derived.

Reuse License

The creator/copyright holder must have agreed to allow distribution of this file through this site.
If you are the creator we strongly encourage you to select the CC Attribution-NonCommercial-ShareAlike option.

If none of the above licenses apply describe the conditions under which this material appears on this site as well as any information about reuse beyond this site.

More Information about reuse and choosing a license

Distributing information on the web generally requires the permission of the copyright holder--usually the original creator. Providing the information we request here will help visitors to this site understand the ways in which they may (legally) use what they find.

If you created this file (and haven't signed away your copyright) then we'd encourage you to select the CC Attribution-NonCommercial-ShareAlike option. You'll retain the copyright to your file and can do as you please with it in the future. Through this choice you are also explicitly allowing others to reuse that file as long as they give you attribution, and don't use it for commercial purposes.

If the file (or content within it) was created by others you'll need their permission. If it predates 1923 or was created by a U.S federal employee (as part of their job) it is likely in the public domain (and we can all do as we choose with it). The original author may also have explicitly stated how it may be reused (e.g. through a creative commons license). You can describe the licensing/reuse situation in the box above.

Without permission you should not upload the file. There are several options in this case:

You can contact the original author to get permission.
You can provide a link to (or a description of how to get) the original material rather than uploading it here.
You can find a substitute that isn't encumbered by copyright.
You can create a substitute yourself. Remember, ideas can't be copyrighted, only particular expressions of those ideas. Of course you'll want to give credit the original author.

The Stanford Copyright and Fair Use Center has more good information about copyright as it applies to academic settings.

NSF Bio sketch:

All uploaded files are public unless you are in a private workspace

Title: A descriptive, human readable title.

e.g. 'Student Handout for Sauerkraut Assignment'

Select the file: Make sure it has an appropriate suffix (e.g. .doc) or specify the type in the Optional Fields below

Description: A very brief description of the file.

Show Optional Fields

File Type:

The system will attempt to determine the correct file type based on the name of the file you've selected. Choosing the correct file type here will override that.

File Name:

e.g. 'student_handout'
This will be the name of the downloaded file. By default the system will generate this based on the title you specified and the type of file. If you specify a name here it will over-ride the automatically generated name. This is generally only useful when uploading file of a type not recognized by the system (not in the list of file types above). In that situation choose File Type: Unknown Binary and include the appropriate suffix in the file name here. e.g. myfile.m3z Avoid spaces or special characters in the file names.

Authorship/Reuse

Either:
I am the author (copyright holder) of the contents of this file and people are allowed to reuse it for non-commercial purposes as long as they give me attribution as described by this creative commons license.
Or

Choose a different authorship/reuse options

Who is the original creator/copyright holder of the information in this file?

Provenance/Acknowledgements

A short description of where the material came from. Include names and institutions of authors and contributors as well as acknowledgment of any work from which this was derived.

Reuse License

The creator/copyright holder must have agreed to allow distribution of this file through this site.
If you are the creator we strongly encourage you to select the CC Attribution-NonCommercial-ShareAlike option.

If none of the above licenses apply describe the conditions under which this material appears on this site as well as any information about reuse beyond this site.

More Information about reuse and choosing a license

Distributing information on the web generally requires the permission of the copyright holder--usually the original creator. Providing the information we request here will help visitors to this site understand the ways in which they may (legally) use what they find.

If you created this file (and haven't signed away your copyright) then we'd encourage you to select the CC Attribution-NonCommercial-ShareAlike option. You'll retain the copyright to your file and can do as you please with it in the future. Through this choice you are also explicitly allowing others to reuse that file as long as they give you attribution, and don't use it for commercial purposes.

If the file (or content within it) was created by others you'll need their permission. If it predates 1923 or was created by a U.S federal employee (as part of their job) it is likely in the public domain (and we can all do as we choose with it). The original author may also have explicitly stated how it may be reused (e.g. through a creative commons license). You can describe the licensing/reuse situation in the box above.

Without permission you should not upload the file. There are several options in this case:

You can contact the original author to get permission.
You can provide a link to (or a description of how to get) the original material rather than uploading it here.
You can find a substitute that isn't encumbered by copyright.
You can create a substitute yourself. Remember, ideas can't be copyrighted, only particular expressions of those ideas. Of course you'll want to give credit the original author.

The Stanford Copyright and Fair Use Center has more good information about copyright as it applies to academic settings.

Download Word Template NSF Biographical Sketch Instructions (Microsoft Word 42kB Aug10 15)

National Science Foundation Requirements

The National Science Foundation provides funding for the operational costs of the workshop plus travel, lodging, and workshop materials for the participants. To be supported by these funds, participants must be either a US citizen, a permanent resident, or in the employ of a US institution. You must check one of the following to submit.

Yes, I meet these requirements.
No, I do not meet these requirements, but am interested in participating in the workshop at my own expense.

Minority Faculty Development Workshop Application

If you are accepted for the workshop, you will be asked to complete a registration form to provide us with more information.

Title: A descriptive, human readable title.

Select the file: Make sure it has an appropriate suffix (e.g. .doc) or specify the type in the Optional Fields below

Description: A very brief description of the file.

File Name:

Authorship/Reuse

Provenance/Acknowledgements

Reuse License

Title: A descriptive, human readable title.

Select the file: Make sure it has an appropriate suffix (e.g. .doc) or specify the type in the Optional Fields below

Description: A very brief description of the file.

File Name:

Authorship/Reuse

Provenance/Acknowledgements

Reuse License