ATTACHMENT 1
COVER PAGE
Please print your name in full:
First Name Middle Name Last Name Suffix (e.g., Jr.)
Cross reference: Birth name or former name legally changed Today’s date
Name of Doctoral Institution City or Branch
Type of Research Doctorate Degree (e.g., Ph.D., Ed.D., etc.) Date Degree Granted
(mm/yyyy)
Survey of Earned Doctorates
July 1, 2013 to June 30, 2014
Conducted by
NORC at the University of Chicago
for
The National Science Foundation
The National Institutes of Health
The U.S. Department of Education
The U.S. Department of Agriculture
The National Endowment for the Humanities
The National Aeronautics and Space Administration
This information is solicited under the authority of the National Science Foundation Act of 1950, as amended. All information you provide is protected under the NSF Act and the Privacy Act of 1974, and will be used only for research or statistical purposes by your doctoral institution, the survey sponsors, their contractors, and collaborating researchers for the purpose of analyzing data, preparing scientific reports and articles, and selecting samples for a limited number of carefully defined follow-up studies. The last four digits of your Social Security Number are also solicited under the NSF Act of 1950, as amended; provision of it is voluntary. It will be kept confidential. It is used for quality control, to assure that we identify the correct persons, especially when data are used for statistical purposes in Federal program evaluation. Any information publicly released (such as statistical summaries) will be in a form that does not personally identify you or other respondents. Your response is voluntary and failure to provide some or all of the requested information will not in any way adversely affect you.
The time needed to complete this form varies according to individual circumstances, but the average time is estimated to be 20 minutes. If you have comments regarding this time estimate, you may write to the National Science Foundation, 4201 Wilson Blvd., Arlington, VA 22230, Attention: NSF Reports Clearance Officer. A Federal agency may not conduct or sponsor a collection of information unless it displays a currently valid OMB control number.
For more information about the Survey of Earned Doctorates, go to http://www.nsf.gov/statistics/doctorates/
PAGE 2
INSTRUCTIONS
Thank you for taking the time to complete this questionnaire. Directions are provided for each question.
If you have not already done so, please print your name on the front cover.
Please print all responses; you may use either a pen or pencil.
PART A - Education
A1. What is the title of your dissertation?
Please mark (X) this box if the title below refers to a performance, project report, or a musical or literary composition required instead of a dissertation.
Title:
A2. Please write the name of the primary field of your dissertation research.
Name of Field
Using the list on page 6, choose the code that best describes the primary field of your dissertation research.
Number of Field
If your dissertation research was interdisciplinary, list the name and number of your secondary field.
Name of Field
Number of Field
If there were more than two fields, please list these additional fields.
Name of Field
Number of Field
Name of Field
Number of Field
A3. Please name the department (or interdisciplinary committee, center, institute, etc.) of the university that supervised your doctoral studies.
Department/Committee/Center/Institute/Program
A4. If you received full or partial tuition remission (waiver) for your doctoral studies, was it:
1 I did not receive any tuition remission
2 for less than 1/3 of tuition
3 between 1/3 and 2/3 of tuition
4 more than 2/3 of tuition but less than full
5 full tuition remission
A5. Please indicate whether each of the following was a source of financial support during graduate school.
Mark (X) Yes or No for each
a. Fellowship, scholarship
b. Grant
c. Teaching assistantship
d. Research assistantship
e. Other assistantship
f. Traineeship
g. Internship, clinical residency
h. Loans (from any source)
i. Personal savings
j. Personal earnings during graduate school (other than sources listed above)
k. Spouse's, partner's, or family’s earnings or savings
l. Employer reimbursement/assistance
m. Foreign (non-U.S.) support
n. Other - Specify
A6. Which TWO sources listed in A5 provided the most support?
Enter letters of primary and secondary sources
1 Primary source of support
2 Secondary source of support
Mark (X) if no secondary source
A7. When you receive your doctoral degree, how much money will you owe that is directly related to your undergraduate and graduate education?
Mark (X) one in each column
a. Undergraduate b. Graduate
1 None 1 None
2 $10,000 or less 2 $10,000 or less
3 $10,001 - $20,000 3 $10,001 - $20,000
4 $20,001 - $30,000 4 $20,001 - $30,000
5 $30,001 - $40,000 5 $30,001 - $40,000
6 $40,001 - $50,000 6 $40,001 - $50,000
7 $50,001 - $60,000 7 $50,001 - $60,000
8 $60,001 - $70,000 8 $60,001 - $70,000
9 $70,001 - $80,000 9 $70,001 - $80,000
10 $80,001 - $90,000 10 $80,001 - $90,000
11 $90,001 or more 11 $90,001 or more
Please specify_________ Please specify________
PAGE 3
A8. The next few questions ask about the degrees you have received. Starting with this doctorate degree, please provide the following information for the most recent master’s degree and your first bachelor’s degree.
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This research doctorate degree |
Most recent master’s degree (e.g. MS, MA, MBA) or equivalent |
First bachelor's degree (e.g. BA, BS, AB) or equivalent |
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a. Have you received a degree of this type? . . |
Yes X |
No |
Yes |
No |
Yes |
No |
b. Month/year degree granted…………….. . . |
Month |
Month |
Month |
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Year |
Year |
Year |
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c. Month/year that you started your degree…. |
Month |
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Month |
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Year |
Year |
Year |
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d. Primary field of study . . . . . . . . . . . . . . . . . |
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e. Field number from list on pp. 6-7. . . . . . . . . |
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f. Institution name . . . . . . . . . . . . . . . . . . . . . |
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g. Branch or city. . . . . . . . . . . . . . . . . . . . . . . |
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h. State or province . . . . . . . . . . . . . . . . . . . . |
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i. Country . . . . . . . . . . . . . . . . . . . . . . . . . . . |
USA |
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A9. Excluding those above, have you attained any additional postsecondary degrees? …
Yes No
If yes, please list the additional degree(s), granting institution(s), and years.
First Additional Degree
Degree type ______________________________
Degree field ______________________________
Field number, pp. 6-7 ______________________________
Month/Year granted ______________________________
Institution ______________________________
Branch or city ______________________________
State or country ______________________________
Second Additional Degree
Degree type ______________________________
Degree field ______________________________
Field number, pp. 6-7 ______________________________
Month/Year granted ______________________________
Institution ______________________________
Branch or city ______________________________
State or country ______________________________
If there are more than two degrees, additional degrees should be reported on the back cover.
PAGE 4
A10. Was a master’s degree a prerequisite for admission to your doctoral program?
Yes No
A11. In what month and year did you first enter any graduate school in any program or capacity?
Month ______ Year __________
A12. How many years were you:
a. taking courses or preparing for exams for this doctoral degree (including a master's degree, if that was part of your doctoral program)?
Years __________
Round to whole years
b. working on your dissertation after coursework and exams (non-course related preparation or research, writing, and defense)?
Years __________
Round to whole years
A13. Was there any time from the year you entered your doctoral program and the award of your doctorate that you were not working on your degree (that is, not taking courses or working on your dissertation)?
Yes No
If
yes, how many years were you not working on your degree?
Years
__________
Round to whole years
A14. Did you earn college credit from a community or two-year college?
Yes No
A15. Are you earning, or have you earned, an MD or a DDS?
Are earning? Have earned?
MD Yes No Yes No
DDS Yes No Yes No
PART B - Postgraduation Plans
B1. In what country or state do you intend to live after graduation (within the next year)?
1 in U.S. State or territory __________
2 not in U.S. Country __________
B2. Do you intend to take a "postdoc" position?
(A "postdoc" is a temporary position primarily for gaining additional education and training in research, usually awarded in academe, industry, or government or a non-profit institution.)
1 Yes
2 No
B3. What is the status of your postgraduate plans (in the next year)?
Mark (X) one
1 Returning to, or continuing in, predoctoral employment
2 Have signed contract or made definite commitment for a “postdoc” or other work
GO TO B4, pg 4
3 Negotiating with one or more specific organizations
4 Seeking position but have no specific prospects
5 Other full-time degree program (e.g., MD, DDS, JD, MBA, etc.)
6 Do not plan to work or study (e.g., family commitments, etc.)
7 Other - Specify
SKIP TO C1, pg 10
B4. What best describes your post-graduation plans (within the next year)?
Mark (X) one
1 “Postdoc” or further training GO TO B4a
2 Employment GO TO B4b
B4a. What best describes the nature of your further training or study?
Mark (X) one
1 “Postdoc” fellowship
2 “Postdoc” research associateship
3 Traineeship
4 Internship, clinical residency
5 Other - Specify
GO TO B5, pg 9
B4b. What best describes the nature of your employment?
Mark (X) one
1 Employment (other than military service)
2 Military service
3 Other Employment - Specify
SKIP to B6, pg 9
PAGE 5
Please turn this page for the Field of Study List
The Field of Study listing on pages 6 and 7 is to be used in responding to items A2, A8, and A9. Please choose the code that best described the name of your field.
PAGE 6
Business Management/Administration 900 Accounting 910 Business Administration & Management 915 Business/Managerial Economics 901 Finance 921 Human Resources Development 912 Hospitality,Food Service&Tourism Management |
916 International Business/Trade/Commerce 920 Marketing Management & Research 917 Management Information Systems/Business Statistics 930 Operations Research (also in ENGINEERING & in MATHEMATICS) |
935 Organizational Behavior (see also PSYCHOLOGY/Industrial & Organizational) 938 Business Management/Administration, General 939 Business Management/Administration, Other |
Communication |
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940 Communication Research 957 Communication Theory |
950 Film, Radio, TV & Digital Communication 947 Mass Communication/Media Studies |
958 Communication, General 959 Communication, Other |
Computer & Information sciences |
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400 Computer Science |
410 Information Science & Systems 415 Robotics |
418 Computer & Information Sciences, General 419 Computer & Information Sciences, Other |
Education Research & Administration |
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840 Counseling Education/Counseling & Guidance 800 Curriculum & Instruction 805 Educational Administration & Supervision 820 Educational Assessment/Testing/Measurement 804 Education & Human Resource Studies/Development |
810 Educational/Instructional Media Design 812 Educational/Instructional Technology 807 Educational Leadership 822 Educational Psychology (also in PSYCHOLOGY) 808 Educational Policy Analysis 815 Educational Statistics/Research Methods |
845 Higher Education/Evaluation & Research 833 International Education 825 School Psychology (also in PSYCHOLOGY) 830 Social/Philosophical Foundations of Education 835 Special Education 806 Urban Education and Leadership |
Teacher Education |
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858 Adult & Continuing Teacher Education 852 Elementary Teacher Education |
850 Pre-elementary/Early Childhood Teacher Education |
856 Secondary Teacher Education |
Teaching Fields |
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860 Agricultural Education 861 Art Education 865 Bilingual & Multilingual Education 864 English Education 863 English as a Second or Foreign Language |
870 Family & Consumer/Human Science (also in Fields Not Elsewhere Classified) 866 Foreign Languages Education 868 Health Education 882 Literacy & Reading Education 874 Mathematics Education
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876 Music Education 878 Nursing Education 880 Physical Education & Coaching 884 Science Education 885 Social Science Education 889 Teacher Education & Professional Development |
Other Education |
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895 Workforce Education and Development |
898 Education, General |
899 Education, Other |
Engineering |
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300 Aerospace, Aeronautical & Astronautical Engineering 303 Agricultural Engineering 306 Bioengineering & Biomedical Engineering 312 Chemical Engineering 315 Civil Engineering 318 Communications Engineering 321 Computer Engineering 324 Electrical, Electronics & Communications Engineering |
376 Engineering Management & Administration 327 Engineering Mechanics 330 Engineering Physics 333 Engineering Science 336 Environmental/Environmental Health Engineering 337 Geotechnical & Geoenvironmental Engineering 339 Industrial & Manufacturing Engineering 342 Materials Science Engineering 345 Mechanical Engineering 348 Metallurgical Engineering |
357 Nuclear Engineering 360 Ocean Engineering 363 Operations Research (also in MATHEMATICS & in BUSINESS MANAGEMENT) 366 Petroleum Engineering 369 Polymer & Plastics Engineering 316 Structural Engineering 372 Systems Engineering 373 Transportation & Highway Engineering 398 Engineering, General 399 Engineering, Other |
Humanities History |
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706 African History 700 American History (U.S. & Canada) 703 Asian History |
705 European History 710 History, Science & Technology & Society 707 Latin American History |
708 Middle/Near East Studies 718 History, General 719 History, Other |
Foreign Languages & Literature |
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768 Arabic 758 Chinese 740 French |
743 German 746 Italian 762 Japanese 750 Latin American |
752 Russian 749 Spanish 769 Other Languages & Literature |
Letters |
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732 American Literature (U.S. & Canada) 720 Classics 723 Comparative Literature 735 Creative Writing |
734 English Language 733 English Literature (British & Commonwealth) 724 Folklore 737 Rhetoric & Composition |
736 Speech & Rhetorical Studies 738 Letters, General 739 Letters, Other
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Other Humanities |
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770 American/U.S. Studies 773 Archaeology 776 Art History/Criticism/Conservation 792 Bible/Biblical Studies 795 Drama/Theater Arts 784 Ethics |
778 Film/Cinema/Video Studies 777 Jewish/Judaic Studies & History 780 Music 786 Music Theory & Composition 787 Music Performance |
788 Musicology/Ethnomusicology 789 Music, Other 785 Philosophy 790 Religion/Religious Studies 798 Humanities, General 799 Humanities, Other |
PAGE 7
Life sciences Agricultural Sciences/Natural Resources |
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000 Agricultural Economics 025 Agricultural & Horticultural Plant Breeding 020 Agronomy & Crop Science 010 Animal Nutrition 014 Animal Science, Poultry (or Avian) 019 Animal Science, Other 081 Environmental Science 055 Fishing & Fisheries Sciences/Management |
043 Food Science 044 Food Science & Technology, Other 066 Forest Sciences & Biology 070 Forest/Resources Management 079 Forestry & Related Science, Other 050 Horticulture Science 074 Natural Resources/Conservation 003 Natural Resource/Environmental Economics (also in SOCIAL SCIENCES) |
030 Plant Pathology/Phytopathology (also in BIOLOGICAL SCIENCES) 039 Plant Sciences, Other 046 Soil Chemistry/Microbiology 049 Soil Sciences, Other 080 Wildlife/Range Management 072 Wood Science & Pulp/Paper Technology 098 Agricultural Sciences/Natural Resources, General 099 Agricultural Sciences/Natural Resources , Other |
Biological/Biomedical Sciences |
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130 Anatomy 110 Bacteriology 100 Biochemistry (see also PHYSICAL SCIENCES/ Chemistry, other) 102 Bioinformatics 103 Biomedical Sciences 133 Biometrics & Biostatistics 105 Biophysics (also in PHYSICS) 107 Biotechnology 129 Botany/Plant Biology 158 Cancer Biology 136 Cell/Cellular Biology & Histology 104 Computational Biology 142 Developmental Biology/Embryology |
139 Ecology 145 Endocrinology 148 Entomology 167 Environmental Toxicology 134 Epidemiology 137 Evolutionary Biology 170 Genetics/Genomics, Human & Animal 151 Immunology 152 Marine Biology & Biological Oceanography 157 Microbiology 154 Molecular Biology 160 Neurosciences & Neurobiology 163 Nutrition Sciences 166 Parasitology |
175 Pathology, Human & Animal 180 Pharmacology, Human & Animal 185 Physiology, Human & Animal 115 Plant Genetics 120 Plant Pathology/Phytopathology (also in AGRICULTURAL SCIENCES) 125 Plant Physiology 155 Structural Biology 169 Toxicology 168 Virology 188 Wildlife Biology 189 Zoology, Other 198 Biology/Biomedical Sciences, General 199 Biology/Biomedical Sciences, Other |
Health Sciences |
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210 Environmental Health 227 Gerontology (also in SOCIAL SCIENCES) 280 Health and Behavior 217 Health Policy Analysis 212 Health Systems/Service Administration |
222 Kinesiology/Exercise Physiology 240 Pharmaceutical Sciences 230 Nursing Science 207 Oral Biology/Oral Pathology 215 Public Health |
245 Rehabilitation/Therapeutic Services 200 Speech-Language Pathology & Audiology 250 Veterinary Sciences 298 Health Sciences, General 299 Health Sciences, Other |
Mathematics |
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425 Algebra 430 Analysis & Functional Analysis 420 Applied Mathematics 460 Computing Theory & Practice 435 Geometry/Geometric Analysis |
440 Logic 445 Number Theory 465 Operations Research (also in ENGINEERING & in BUSINESS MANAGEMENT/ADMIN.)
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450 Statistics (also in SOCIAL SCIENCES) 455 Topology/Foundations 498 Mathematics/Statistics, General 499 Mathematics/Statistics, Other |
Physical sciences Astronomy |
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500 Astronomy |
505 Astrophysics |
509 Astronomy, Other |
Atmospheric Science & Meteorology |
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510 Atmospheric Chemistry & Climatology 512 Atmospheric Physics & Dynamics |
514 Meteorology 518 Atmospheric Science/Meteorology, General |
519 Atmospheric Science/Meteorology, Other |
Chemistry |
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520 Analytical Chemistry 522 Inorganic Chemistry 528 Medicinal Chemistry 526 Organic Chemistry |
530 Physical Chemistry 532 Polymer Chemistry 534 Theoretical Chemistry |
538 Chemistry, General 539 Chemistry, Other (see also BIOLOGICAL/ Biochemistry) |
Geological & Earth Sciences |
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542 Geochemistry 540 Geology 552 Geomorphology & Glacial Geology |
544 Geophysics & Seismology 548 Mineralogy & Petrology 546 Paleontology |
550 Stratigraphy & Sedimentation 558 Geological & Earth Sciences, General 559 Geological & Earth Sciences, Other |
Ocean/Marine Sciences |
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585 Hydrology & Water Resources 590 Oceanography, Chemical & Physical |
595 Marine Sciences 599 Ocean/Marine, Other |
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Physics |
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560 Acoustics 576 Applied Physics 561 Atomic/Molecular/Chemical Physics 565 Biophysics (also in BIOLOGICAL SCIENCES) |
574 Condensed Matter/Low Temperature Physics 577 Medical Physics/Radiological Science 568 Nuclear Physics 569 Optics/Phototonics 564 Particle (Elementary) Physics |
570 Plasma/Fusion Physics 572 Polymer Physics 578 Physics, General 579 Physics, Other |
Psychology |
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602 Behavioral Analysis 600 Clinical Psychology 603 Cognitive Psychology & Psycholinguistics 609 Counseling 612 Developmental & Child Psychology 618 Educational Psychology (also in EDUCATION) |
615 Experimental Psychology 620 Family Psychology 614 Health & Medical Psychology 613 Human Development & Family Studies 621 Industrial & Organizational (see also BUSINESS MANAGEMENT/Organization. Behavior) 627 Neuropsychology/Physiological Psychology |
624 Personality Psychology 633 Psychometrics & Quantitative Psychology 636 School Psychology (also in EDUCATION) 639 Social Psychology 648 Psychology, General 649 Psychology, Other |
Social sciences |
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650 Anthropology, General 655 Anthropology, Cultural 656 Anthropology, Physical and Biological 652 Area /Ethnic/Cultural Studies 657 Criminal Justice & Corrections 658 Criminology 662 Demography/Population Studies 668 Econometrics 667 Economics |
651 Gender and Women’s Studies 670 Geography 684 Gerontology (also in HEALTH SCIENCES) 674 International Relations/Affairs 676 Linguistics 665 Natural Resource/Environmental Economics (also in AGRICULTURAL SCIENCES) 685 Natural Resource/Environmental Policy
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678 Political Science & Government 682 Public Policy Analysis 686 Sociology 690 Statistics (also in MATHEMATICS) 694 Urban Affairs/Studies 695 Urban/City, Community & Regional Planning 698 Social Sciences, General 699 Social Sciences, Other |
Fields Not Elsewhere Classified (NEC) |
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960 Architecture/Environmental Design 964 Family/Consumer Science/Human Science (also in EDUCATION) 968 Law |
972 Library Science 974 Parks/Sports/Rec./Leisure/Fitness 976 Public Administration 980 Social Work |
984 Theology/Religious Education (see also OTHER HUMANITIES/Religion/Religious Studies, Ethics) 989 Other Fields, NEC |
PAGE 8
Back cover of FOS list
PAGE 9
B5. (If “postdoc” or further training) What will be the main source of financial support for your “postdoc” or further training within the next year?
Mark (X) one
1 U.S. government
2 Industry/business
3 College or university
4 Private foundation
5 Nonprofit, other than private foundation or college
6 Foreign government
7 Other - Specify
8 Unknown
B6. What type of principal employer will you be working for (or training with) in the next year?
Mark (X) one
EDUCATION
1. U.S. 4-year college or university other than medical school
2. U.S. medical school (including university-affiliated hospital or medical center)
3. U.S. university-affiliated research institute
4. U.S. community or two-year college
5. U.S. preschool, elementary, middle, secondary school or school system
6. Foreign educational institution
GOVERNMENT (other than education institution)
7. Foreign government
8. U.S. federal government
9. U.S. state government
10. U.S. local government
PRIVATE SECTOR (other than education institution)
11. Not for profit organization
12. Industry or business (for profit)
OTHER
13. Self-employed
14. Other - Specify
B7. Please name the organization and geographic location where you will work or study.
Organization _______________
State or territory (if U.S.) _______________
OR
Country (if not U.S.) _______________
Is this a college or a university? Yes No
B8. What will be your basic annual salary for this principal job (in the next year)? Do not include bonuses or additional compensation for summertime teaching of research. If you are not salaried, please estimate your earned income.
$____________________________
If you prefer not to report an exact amount, please indicate into which range you expect your salary to fall:
1 $30,000 or less 7 $70,001 - $80,000
2 $30,001 - $35,000 8 $80,001 - $90,000
3 $35,001 - $40,000 9 $90,001 - $100,000
4 $40,001 - $50,000 10 $100,001 - $110,000
5 $50,001 - $60,000 11 $110,001 or more
6 $60,001 - $70,000 12 Don’t know
B9. How many months does this salary cover?
Number of months _________
(1-12)
B10. What will be your primary and secondary work activities?
Mark (X) one in each column
a. Primary b. Secondary
Research and development 1 1
Teaching 2 2
Management or administration 3 3
Professional services to individuals 4 4
Other - Specify 5 5
Mark (X) if no secondary work activities.
PAGE 10
PART C - Background Information
C1. Are you –
1 Male
2 Female
C2. What is your marital status?
Mark (X) one
1 Married
2 Living in a marriage-like relationship
3 Widowed
4 Separated
5 Divorced
6 Never married
C3. Not including yourself or your spouse/partner, how many dependents (children or adults) do you have – that is, how many others receive at least one half of their financial support from you?
Write in Number
5 years of age or younger ____
6 to 18 years ____
19 years or older ____
Mark (x) box if none
C4. What is the highest educational attainment of your mother and father?
Mark (X) one for each parent
a. Mother b. Father
Less than high/secondary school graduate 1 1
High/secondary school graduate 2 2
Some college 3 3
Bachelor's degree 4 4
Master's degree 5 5
(e.g., MA, MS, MBA, MSW, etc.)
Professional degree 6 6
(e.g., MD, DDS, JD, D.Min, Psy.D., etc.)
Research doctoral degree 7 7
Not applicable/Unknown 8 8
C5. What is your place of birth?
State or territory (if U.S.)__________
OR
Country (if not U.S.) __________
C6. What is your date of birth?
Month _________ Day _________ Year 19
C7. What is your citizenship status?
Mark (X) one
U.S. CITIZEN
1 Since birth
2 Naturalized
SKIP TO C9
NON-U.S. CITIZEN
3 With a Permanent U.S. Resident Visa ("Green Card")
4 With a Temporary U.S. Visa
GO TO C8
C8. (IF A NON-U.S. CITIZEN) Of which country are you a citizen?
(Specify country of present citizenship)
C9. In what state or country was the high school/secondary school that you last attended?
State or territory (if U.S.) __________
OR
Country (if not U.S.) __________
C10. Are you Hispanic or Latino?
Mark (X) one
No, I am not Hispanic or Latino
Yes, I am Mexican or Chicano
Yes, I am Puerto Rican
Yes, I am Cuban
Yes, I am Other Hispanic or Latino – Specify____________________
C11. What is your racial background?
Mark (X) one or more
a. American Indian or Alaska Native
Specify tribal affiliation(s)
b. Native Hawaiian or other Pacific Islander
c. Asian
d. Black or African-American
e. White
PAGE 11
C12. The following several questions are designed to help us better understand the educational paths of individuals with specific functional limitations. What is the USUAL degree of difficulty you have with...
Mark (X) one for each item. None Slight Moderate Severe Unable to do
1 SEEING words or letters in ordinary 1 2 3 4 5
newsprint (with glasses/contact lenses,
if you usually wear them)
2 HEARING what is normally said in 1 2 3 4 5
conversation with another person (with
hearing aid, if you usually wear one)
3 WALKING without human or mechanical 1 2 3 4 5
assistance or using stairs
4 LIFTING or carrying something as heavy 1 2 3 4 5
as 10 pounds, such as a bag of groceries
5 CONCENTRATING, REMEMBERING, 1 2 3 4 5
or MAKING DECISIONS because of a
physical, mental, or emotional condition
C13. Mark this box if you answered ―None to all the activities in question C12, and go to question C15.
C14. What is the earliest age at which you first began experiencing any difficulties in any of these areas?
Age _____ OR Since birth
C15. Please fill in the last four digits of your Social Security Number.
XXX – XX - ___ ___ ___ ___
REMINDER: ALL INFORMATION YOU PROVIDE WILL BE TREATED AS CONFIDENTIAL and used only for research or statistical purposes by your doctoral institution, the survey sponsors, their contractors, and collaborating researchers for the purpose of analyzing data, preparing scientific reports and articles, and selecting samples for a limited number of carefully defined follow-up studies.
C16. In case we need to clarify some of the information you have provided, please list your current address, an e-mail address and telephone number where you can be reached.
Your current street address:
City State Country Zip or Postal Code
E-mail address
Daytime or cell telephone
C17. Please provide the name and address of a person who is likely to know where you can be reached in case your address changes in the near future.
__________________________________
Name of person who will know where you can be reached
__________________________________________
Street address
City State Country Zip or Postal Code
Phone Number (Including area or country code)
E-mail address
Thank you for completing the questionnaire.
Please use the back cover to make any additional comments you may have about this survey.
The results of this survey will be published in an annual report; the annual reports on earlier surveys are available at http://www.norc.uchicago.edu/sed
Please return this questionnaire to your GRADUATE SCHOOL for forwarding to Survey of Earned Doctorates, NORC at the University of Chicago, 1 N. State Street, Floor 16, Chicago, IL 60602.
If you have questions or concerns about the survey, you may contact us by e-mail at 4800-sed@norc.uchicago.edu or phone at 1-800-248-8649.
For more information about the SED, go to www.nsf.gov/statistics/doctorates/
If you have questions about your rights as a study participant, you may call the NORC IRB Administrator toll free at 1-866-309-0542
To the Doctorate Recipient:
Congratulations on earning a doctoral degree!
This is an important accomplishment for you. Your accomplishment is also significant for both this nation and others, as the new knowledge generated by research doctorates enhances the quality of life in this country and throughout the world. Because of the importance of persons earning research doctorates, several Federal agencies—listed on the cover—sponsor this Survey of Earned Doctorates.
The basic purpose of this survey is to gather objective data about doctoral graduates. These data are important in improving graduate education both at your home institution and beyond. Often, decisions made by governmental and private agencies to develop new programs, or to support present ones, are based in part on the data developed from this survey. If you have any comments about the survey, please provide them in the space below.
ADDITIONS TO QUESTIONS
A9. (continued from page 3)
Third Additional Degree
Degree type _____________________
Degree field _____________________
Field number, pp. 6-7 _____________________
Month/Year granted _____________________
Institution _____________________
Branch or city _____________________
State or country _____________________
Fourth Additional Degree
Degree type _____________________
Degree field _____________________
Field number, pp. 6-7 _____________________
Month/Year granted _____________________
Institution _____________________
Branch or city _____________________
State or country _____________________
On behalf of the sponsoring Federal agencies, I thank you for your participation in this survey.
Best wishes,
Dr. Lynda T. Carlson
National Science Foundation
Comments about the Survey
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