Academic Research Infrastructure Program: Recovery and Reinvestment (ARI-R²) Reviewer Background

Reviewer Background Information
All required fields marked by asterisks (*).
First Name *
Middle Initial
Last Name *
Position or Academic Rank*
Administrative Title (if any)
Department, Section, or Other Unit *
Institution or Organization *
Street Address *
City *
State *	Select: Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska Nevada New Hampshire New Jersey New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Other
Zip *
Phone *
Fax
Email *
Gender	Male Female
Ethnicity	Hispanic or Latino Not Hispanic or Latino
Race (check one or more)	American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Asian White Black or African American
Disability Status (check one or more)	Hearing Impairment Visual Impairment Mobility/Orthopedic Impairment Other None
Type of Employing Institution *	Public University/College Private University/College Business/Industry Government Agency K-12 or School System Other
If University/College, indicate the highest degree awarded by the institution:	Associate Baccalaureate Masters Doctorate
If K-12 School, indicate grade level(s):

Education	Institution	Discipline	Year of Degree
B.S. (or equiv.)
Masters (or equiv.)
Ph.D. (or equiv.)
Postdoctoral

Areas of Expertise or Special Interest
Most recent panel review at NSF (if applicable):	Program	Month/Year