wpform test page
Please enable JavaScript in your browser to complete this form.
-
Step
1
of 3
Required
Name
*
First
Last
Pronoun (Select all that apply)
*
he/him
she/her
they/them
Email
*
Zip Code
*
Institution
*
Job Title
*
Career Stage
*
Undergraduate student
PhD student
Early-career professional (less than 10 years post degree)
Mid-career professional (10-20 years post degree)
Late-career professional (more than 20 years post degree)
NASA Division (Select all that apply)
*
Solar System - planetary bodies and small worlds
Solar Physics - characteristics of our star and/or its effects across our solar system
Earth Science - any Earth related work across any sphere (biosphere, atmosphere, lithosphere, etc) and/or effects of space on the Earth
Humans in Space - biological experiments for and in space and impact of space on humans
Astronomy - all things extrasolar
Astrobiology
Other
Next
Optional
Which of the following racial or ethnic categories do you identify with? (Select all that apply)
American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Black or African American - A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American."
Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term, "Spanish origin," can be used in addition to "Hispanic or Latino."
Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
I do not wish to answer.
Do you identify as a member of a historically marginalized group?
Yes
No
If there is any additional information you would like to share regarding your identify, please include it below.
It is our goal to represent subject matter experts with diverse backgrounds and abilities. For the purposes of measuring our progress toward this goal, we offer the opportunity for self-identification of a disability. Your response is confidential.
Yes, I have a disability
No, I do not have a disability
I do not wish to answer
If there is any additional information you would like to share regarding your self-identified disability, please include it below.
Which of the following represents your current interest?
Send me emails about opportunities
Make my information privately available to SciAct teams seeking SMEs for engagement
I'm seeking connection with a SciAct team to discuss Seed Grant Opportunities
Previous
Next
Which of these opportunity types are of greatest interest to you? (Select all that apply)
Funding
Virtual training
Requests for SMEs
In-person training
Networking
Are you a US citizen or green card holder?
Yes
No
Are you a civil servant?
Yes
No
Would you like to complete your profile?
Yes
No
Do you already have a SciAct team in mind?
Yes
No
Are you a US citizen or green card holder?
Yes
No
Sorry, you are ineligible to receive Seed Grant funding, but we are happy to connect you with SciAct teams for unfunded opportunities. Would you like to complete your profile now?
Yes
No
Are you a civil servant?
Yes
No
Which SciAct team would you like us to connect you with?
Do you already have a project idea in mind? Tell us your idea in 100 words or less.
Would you be willing to make your information publicly available on the
NASA SME Map
for the general public? NASA SMD would contact you directly if a member of the general public would like to connect with you.
Yes
No
What is your scientific expertise?
How many times a year are you interested in engaging with education/outreach activities?
1
2
3-5
more than 5
How would you describe your amount of experience working in educational and outreach activities?
I have no experience (novice)
I've engaged a couple of times (beginner)
I have engaged many times (proficient)
I regularly participate in outreach and have for many years (expert)
Have you participated in science communication training through any of the following organizations? (Select all that apply)
AAAS
AGU
Alan Alda Center
None
Upon request, would you be able to provide a certificate of completion or similar documentation?
Yes
No
What is your desired audience age? (Select all that apply)
0-4
5-10
11-14
15-18
19-22
23-26
27-99
What are your preferred engagement types? (Select all that apply)
Content review
Presentations
Demos
Outreach
Interviews
Mentoring
What are your preferred learning context types? (Select all that apply)
Home/Family
Citizen Science
Neighborhood/Community
Digital Learning
Informal/Out of School
Formal Education
What time zone do you live in?
Please help us share information about you with SciAct. Enter a short biography here (~50 words).
Profile Image (Please upload an image)
Click or drag a file to this area to upload.
Which formats do you prefer for participation? (Select all that apply)
In-person
Virtual
Asynchronous
How far are you willing to travel for in-person events? (Select all that apply)
less than 25 miles
25-50 miles
more than 50 miles
How much time are you willing to invest per interactions? (Select all that apply)
1 hour
2 hours
3-5 hours
more than 5 hours
Please list any languages, apart from English, in which you would be comfortable engaging in educational and outreach activities.
What are 5-10 key words about your expertise you would use as a description to the general public? (Ex: volcanoes, Mars, star formation, climate change, asteroids, etc.)
Are you ready to complete your registration? If yes, select the
Submit
button below.
Previous
Submit
Please enable JavaScript in your browser to complete this form.
-
Step
1
of 3
Required
Name
*
First
Last
Pronoun (Select all that apply)
*
he/him
she/her
they/them
Email
*
Zip Code
*
Institution
*
Job Title
*
Career Stage
*
Undergraduate student
PhD student
Early-career professional (less than 10 years post degree)
Mid-career professional (10-20 years post degree)
Late-career professional (more than 20 years post degree)
NASA Division (Select all that apply)
*
Solar System - planetary bodies and small worlds
Solar Physics - characteristics of our star and/or its effects across our solar system
Earth Science - any Earth related work across any sphere (biosphere, atmosphere, lithosphere, etc) and/or effects of space on the Earth
Humans in Space - biological experiments for and in space and impact of space on humans
Astronomy - all things extrasolar
Astrobiology
Other
Next
Optional
Which of the following racial or ethnic categories do you identify with? (Select all that apply)
American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Black or African American - A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American."
Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term, "Spanish origin," can be used in addition to "Hispanic or Latino."
Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
I do not wish to answer.
Do you identify as a member of a historically marginalized group?
Yes
No
If there is any additional information you would like to share regarding your identify, please include it below.
It is our goal to represent subject matter experts with diverse backgrounds and abilities. For the purposes of measuring our progress toward this goal, we offer the opportunity for self-identification of a disability. Your response is confidential.
Yes, I have a disability
No, I do not have a disability
I do not wish to answer
If there is any additional information you would like to share regarding your self-identified disability, please include it below.
Which of the following represents your current interest?
Send me emails about opportunities
Make my information privately available to SciAct teams seeking SMEs for engagement
I'm seeking connection with a SciAct team to discuss Seed Grant Opportunities
Previous
Next
Which of these opportunity types are of greatest interest to you? (Select all that apply)
Funding
Virtual training
Requests for SMEs
In-person training
Networking
Are you a US citizen or green card holder?
Yes
No
Are you a civil servant?
Yes
No
Would you like to complete your profile?
Yes
No
Do you already have a SciAct team in mind?
Yes
No
Are you a US citizen or green card holder?
Yes
No
Sorry, you are ineligible to receive Seed Grant funding, but we are happy to connect you with SciAct teams for unfunded opportunities. Would you like to complete your profile now?
Yes
No
Are you a civil servant?
Yes
No
Which SciAct team would you like us to connect you with?
Do you already have a project idea in mind? Tell us your idea in 100 words or less.
Would you be willing to make your information publicly available on the
NASA SME Map
for the general public? NASA SMD would contact you directly if a member of the general public would like to connect with you.
Yes
No
What is your scientific expertise?
How many times a year are you interested in engaging with education/outreach activities?
1
2
3-5
more than 5
How would you describe your amount of experience working in educational and outreach activities?
I have no experience (novice)
I've engaged a couple of times (beginner)
I have engaged many times (proficient)
I regularly participate in outreach and have for many years (expert)
Have you participated in science communication training through any of the following organizations? (Select all that apply)
AAAS
AGU
Alan Alda Center
None
Upon request, would you be able to provide a certificate of completion or similar documentation?
Yes
No
What is your desired audience age? (Select all that apply)
0-4
5-10
11-14
15-18
19-22
23-26
27-99
What are your preferred engagement types? (Select all that apply)
Content review
Presentations
Demos
Outreach
Interviews
Mentoring
What are your preferred learning context types? (Select all that apply)
Home/Family
Citizen Science
Neighborhood/Community
Digital Learning
Informal/Out of School
Formal Education
What time zone do you live in?
Please help us share information about you with SciAct. Enter a short biography here (~50 words).
Profile Image (Please upload an image)
Click or drag a file to this area to upload.
Which formats do you prefer for participation? (Select all that apply)
In-person
Virtual
Asynchronous
How far are you willing to travel for in-person events? (Select all that apply)
less than 25 miles
25-50 miles
more than 50 miles
How much time are you willing to invest per interactions? (Select all that apply)
1 hour
2 hours
3-5 hours
more than 5 hours
Please list any languages, apart from English, in which you would be comfortable engaging in educational and outreach activities.
What are 5-10 key words about your expertise you would use as a description to the general public? (Ex: volcanoes, Mars, star formation, climate change, asteroids, etc.)
Are you ready to complete your registration? If yes, select the
Submit
button below.
Previous
Submit