Please email the completed form to: career@ksu.edu

Registration Form

(Please send your two-page NSF CV along with this registration form.)

Name: _____________________

School: _____________________

Department: _____________________

Phone: _____________________

Email: _____________________

Do you plan to stay at Radisson Hotel Maingate-Anaheim? (The hotel has agreed to give workshop attendees a discount rate of $69 + tax. They need to know how many rooms that the workshop participants need.)

YES NO

Additional questions for assistant professors

(1) How many times have you already submitted CAREER proposals? 0 1 2 3

(2) Do you plan to submit your next CAREER proposal in 2005? YES NO

(3) DO you submit your CAREER proposal to DMII? YES NO

Additional questions for post-doctoral fellows and near-graduation Ph.D. students

(1) In which year did (will) you get your Ph.D. degree? _______________

(2) Have you been involved in writing any NSF proposals? YES NO

(3) Have you taught any courses? YES NO