AskCHIPS screen shots final

This side is showing the full form in its entirety for a non-DOC user. A user
would have to zoom out to see the form like this. The following slides will
break this form down and show each section as the user will see them at a
normal scale. The first set of slides will flow through the fields for a non-DOC
user. The second set will flow through the screens for a DOC user.
Requestor Information Section
Contact Information Section

Information About this Request Section

Information About this Request Section [continued]

Disclosures, etc… Section

Non-Dept of Commerce User

Requestor Information Section for a non-DOC user

As soon as we can, we will include an icon called a “Tool Tip” that when the user puts their
mouse over the icon a pop-up window (small) is displayed that will state something like,
“Mis-representation of your status will result in the request being rejected”.

Values: Yes/No

Contact Information Section for a non-DOC user

Information about this request Section for a non-DOC user
(is the same for a DOC user)

Drop Down Values: Announcement, Briefing, Event, Fireside Chat,
Interview, Keynote, Meeting, Panel, Roundtable, Webinar

Drop Down Values: Onsite
Virtual

Field only appears if answer to “Will the event be onsite or virtual?” is Onsite

Field only appears if answer to “Will the event be onsite or virtual?” is Onsite
Drop Down Values: [2 letter codes for all US states]

Drop Down Values: Yes
No
Field only appears if answer to “Please select if there will be a CHIPS
or DOC speaking role” is “Yes”.
Drop Down Values:
Secretary of Commerce - Gina Raimondo
Deputy Secretary - Don Graves
Under Secretary of Commerce/Director of NIST - Laurie Locascio
CHIPS Program Office Director - Michael Schmidt
CHIPS R&D Office Director
NSTC Director
CHIPS R&D Metrology Director
Other

Field only appears if answer to “Please select if there will be a CHIPS or DOC speaking
role” is “Yes”.

Information About this Request Section [continued] for a non-DOC user
(is the same for a DOC user)

Drop Down Values:
Yes
No

Field only appears if answer to “Will
press be present?” is Yes

Disclosures for a non-DOC user
(is the same for a DOC user)

PRIVACY ACT NOTICE

The collection, maintenance, and disclosure of this information is governed by the Privacy Act of 1974 (5 U.S.C. § 552a).
Authority: The CHIPS Incentives Program is authorized by Title XCIX—Creating Helpful Incentives to Produce Semiconductors for America of the William M. (Mac) Thornberry National Defense
Authorization Act for Fiscal Year 2021 (Pub. L. 116-283, referred to as the CHIPS Act or Act), as amended by the CHIPS Act of 2022 (Division A of Pub. L. 117-167).
Purpose: Information provided will be used by the CHIPS External Affairs Office to schedule and coordinate engagements with CHIPS stakeholders.
Routine Uses: The information is used for the purposes set forth above and may be shared with Department of Commerce staff for work-related purposes. In addition to those disclosures
generally permitted under the Privacy Act of 1974, as amended, § 5 U.S.C. 552a(b), records maintained as part of this system of records may be disclosed subject to all of the published routine
uses as identified in the Privacy Act System of Records Notice COMMERCE/DEPT-10, Executive Correspondence Files.
Voluntary Disclosure: Providing the information requested on this form is voluntary. CHIPS engagement requests may be submitted via the web portal at https://askchips.chips.gov/ or the
engagement request can be logged by a Department employee as a result of an engagement with an interested entity submitted via email, phone, or any means of contact. The web form
submission is preferred as a simple method to provide all information associated with an engagement request. If submission is via any system other than the web-based application, a
Department employee will submit the information into the system.

Dept of Commerce User

Requestor Information Section for a DOC user

If the user answers
“Yes” to this
question, the next
field below
appears.
Field only appears if “Do you currently work for the Department of Commerce” field = Yes;
Drop Down Values: Proactive, Reactive

Requestor Information Section for a DOC user

If the user answers “Reactive” to this
question, the next field appears.

Reactive

Field only appears if “Do you currently work for the Department of Commerce?” field = Yes and if “Is this
request proactive or reactive?” field = Reactive;
Drop Down Values: Yes/No

Contact Information Section for a DOC user
These fields only appear if the user selected “Yes” in the “Do you currently
work for the Department of Commerce?” field (see previous slide).

Information about this request Section for a DOC user
(is the same for a non-DOC user)

Drop Down Values: Announcement, Briefing, Event, Fireside
Chat, Interview, Keynote, Meeting, Panel, Roundtable, Webinar

Drop Down Values: Onsite
Virtual

Field only appears if answer to “Will the event be onsite or virtual?” is Onsite

Field only appears if answer to “Will the event be onsite or virtual?” is Onsite
Drop Down Values: [2 letter codes for all US states]

Drop Down Values: Yes
No
Field only appears if answer to “Please select if there will be a CHIPS
or DOC speaking role” is “Yes”.
Drop Down Values:
Secretary of Commerce - Gina Raimondo
Deputy Secretary - Don Graves
Under Secretary of Commerce/Director of NIST - Laurie Locascio
CHIPS Program Office Director - Michael Schmidt
CHIPS R&D Office Director
NSTC Director
CHIPS R&D Metrology Director
Other

Field only appears if answer to “Please select if there will be a CHIPS or DOC speaking
role” is “Yes”.

Information About this Request Section [continued] for a DOC user
(Is the same for a non-DOC user)

Drop Down Values:
Yes
No

Field only appears if answer to “Will
press be present?” is Yes

Disclosures for a DOC user
(is the same for a non-DOC user)

PRIVACY ACT NOTICE

The collection, maintenance, and disclosure of this information is governed by the Privacy Act of 1974 (5 U.S.C. § 552a).
Authority: The CHIPS Incentives Program is authorized by Title XCIX—Creating Helpful Incentives to Produce Semiconductors for America of the William M. (Mac) Thornberry National Defense
Authorization Act for Fiscal Year 2021 (Pub. L. 116-283, referred to as the CHIPS Act or Act), as amended by the CHIPS Act of 2022 (Division A of Pub. L. 117-167).
Purpose: Information provided will be used by the CHIPS External Affairs Office to schedule and coordinate engagements with CHIPS stakeholders.
Routine Uses: The information is used for the purposes set forth above and may be shared with Department of Commerce staff for work-related purposes. In addition to those disclosures
generally permitted under the Privacy Act of 1974, as amended, § 5 U.S.C. 552a(b), records maintained as part of this system of records may be disclosed subject to all of the published routine
uses as identified in the Privacy Act System of Records Notice COMMERCE/DEPT-10, Executive Correspondence Files.
Voluntary Disclosure: Providing the information requested on this form is voluntary. CHIPS engagement requests may be submitted via the web portal at https://askchips.chips.gov/ or the
engagement request can be logged by a Department employee as a result of an engagement with an interested entity submitted via email, phone, or any means of contact. The web form
submission is preferred as a simple method to provide all information associated with an engagement request. If submission is via any system other than the web-based application, a
Department employee will submit the information into the system.

All Fields shown with drop
downs

Values: Yes/No

Field only appears if “Do you currently work for the Department of
Commerce” field = Yes;
Values: Proactive, Reactive

Field only appears if “Do you currently work for the Department of
Commerce?” field = Yes and if “Is this request proactive or reactive?”
field = Reactive;
Values: Yes/No

Field only appears if “Do you currently work for
the Department of Commerce” field = Yes;

Field only appears if “Do you currently work for
the Department of Commerce” field = Yes;

No dropdowns

Field only appears if “Do you currently work for
the Department of Commerce” field = Yes;

Values: Announcement, Briefing, Event, Fireside Chat,
Interview, Keynote, Meeting, Panel, Roundtable, Webinar

Values: Onsite, Virtual

Field only appears if Onsite

Field only appears if Onsite;
Values: [2 letter codes for all US states]

Values: Yes/No

Field only appears if Speaking Role = Yes;
Values: Secretary of Commerce - Gina Raimondo; Deputy
Secretary - Don Graves; Under Secretary of
Commerce/Director of NIST - Laurie Locascio; CHIPS Program
Office Director - Michael Schmidt; CHIPS R&D Office Director;
NSTC Director; CHIPS R&D Metrology Director; Other

Field only appears if Speaking Role = Yes

Values: Yes/No

Field only appears if Press = Yes

PRIVACY ACT NOTICE

The collection, maintenance, and disclosure of this information is governed by the Privacy Act of 1974 (5 U.S.C. § 552a).
Authority: The CHIPS Incentives Program is authorized by Title XCIX—Creating Helpful Incentives to Produce Semiconductors for America of the William M. (Mac) Thornberry National Defense
Authorization Act for Fiscal Year 2021 (Pub. L. 116-283, referred to as the CHIPS Act or Act), as amended by the CHIPS Act of 2022 (Division A of Pub. L. 117-167).
Purpose: Information provided will be used by the CHIPS External Affairs Office to schedule and coordinate engagements with CHIPS stakeholders.
Routine Uses: The information is used for the purposes set forth above and may be shared with Department of Commerce staff for work-related purposes. In addition to those disclosures
generally permitted under the Privacy Act of 1974, as amended, § 5 U.S.C. 552a(b), records maintained as part of this system of records may be disclosed subject to all of the published routine
uses as identified in the Privacy Act System of Records Notice COMMERCE/DEPT-10, Executive Correspondence Files.
Voluntary Disclosure: Providing the information requested on this form is voluntary. CHIPS engagement requests may be submitted via the web portal at https://askchips.chips.gov/ or the
engagement request can be logged by a Department employee as a result of an engagement with an interested entity submitted via email, phone, or any means of contact. The web form
submission is preferred as a simple method to provide all information associated with an engagement request. If submission is via any system other than the web-based application, a
Department employee will submit the information into the system.