TIP Reviewer Interest Form

Reviewer Interest Form – TIP Directorate

The primary purpose of the Reviewer Interest Form is to provide a platform for the National Science Foundation (NSF)’s Directorate for Technology, Innovation and Partnerships (TIP) to engage and recruit suitable individuals as proposal reviewers. Programs within NSF rely on the expertise and judgement of reviewers in evaluating proposals submitted to these highly competitive programs. In addition to providing valuable inputs to NSF, reviewers report that they, too, benefit professionally from serving on NSF review panels—ranging from engaging with other like-minded individuals in intellectual discussions, to enriching their technical knowledge and understandings in cross-cutting research, and growing their professional networks.

The information requested on this form is pursuant to the National Science Foundation Act of 1950, as amended. Disclosure of all information is entirely voluntary. The purpose of this information is to assist in the identification of prospective panelists and reviewers for the specialized and specific programs within the TIP Directorate. Except for these purposes, this information will not be disclosed except as part of statistical reports or in a form that would not allow identification of individuals. Persons who send in the Reviewer Information Form may not be invited to review immediately, but this information is retained for future reference in selecting reviewers.

Thank you for your interest and support!

The OMB control number for this collection is 3145-XXXX. Public reporting burden for this collection of information is estimated to average 5-15 minutes per response, including the time for reviewing instructions.

Contact Information

1. *Name

   • Last Name:

   • First Name:

   • Middle Initial:

2. *Email address:

3. Phone Number:

   • *Primary:

   • Mobile:

4. Is your primary domicile located within the United States?

   • Yes

   • No (please specify)

Employment Information

5. *Employment/Job Title:

6. *Employing Institution or Organization:

7. *Employing Institution or Organization Location

   • City:

   • State:

   • Country:

8. *Type(s) of Employing Institution:

Select all that apply

• Public University/College

• Private University/College

• K-12 School or School System

• Federal Government Agency

• State/Local Government Agency

• Venture Capital (VC) Firm, or Venture Studio

• For profit organization (excluding VC Firm, Venture Studio, Incubator, and Accelerator)

• Non-profit organization (excluding Incubator and Accelerator)

• Startup company

• Self-employed

• Incubator/Accelerator

• Other (please specify)

9. If selected `Public University/College` or `Private University/College` from the previous question, has the selected university/college been identified as:

Select all that apply

• Minority Serving Institution (this includes Historically Black College or University (HBCU), Hispanic Serving Institution (HSI), and Native American-Serving Non-Tribal Institutions (NASNTIs))

• Primary Undergraduate Institution

• Technical College

• Tribal University/College

• Other (please specify)

• None of the above

Domain Expertise/Professional Interests

10. *Highest Degree obtained:

    • Bachelor of Science (or equivalent)

    • Master of Science (or equivalent)

    • Doctor of Philosophy (or equivalent)

    • Professional Degree (M.D., J.D., D.D.S, or equivalent)

    • Other (please specify)

11. Year (YYYY) in which the highest degree was conferred:

12. *Areas of Expertise (provide at least one, and up to 8).

(Areas of expertise can be grouped by scientific/industry topic areas (e.g. Artificial Intelligence, Quantum Computing, Semiconductor, etc.) as well as categorized into Functional Expertise (Economic Development, Research Development, Workforce Development), with both drop-down options and/or free text provided for the respondent to select and fill in.)

13. Professional and/or LinkedIn web page(s) that provides more information on your skills and/or professional interests:

• Professional webpage URL:

• LinkedIn webpage URL:

14. Are you an Angel, Venture Capital, and/or Institutional investor?

    • Yes

    • No

Previous Reviewer Experience

15. Have you served as an NSF reviewer before?

    • Yes

    • No

16. If `Yes` to the last question, when was the most recent review?

    • MM/YYYY

Demographics

17. Gender

    • Male

    • Female

    • Do not wish to provide

18. Race

Select all that apply

• American Indian or Alaska Native

• Asian

• Black or African American

• Native Hawaiian or Other Pacific Islander

• White

• Other (please specify)

• Do not wish to provide

19. Ethnicity

    • Hispanic or Latino

    • Not Hispanic or Latino

    • Other (please specify)

    • Do not wish to provide

20. Disability Status

Select all that apply

• Hearing Impairment

• Visual Impairment

• Mobility/Orthopedic Impairment

• Other (please specify)

• None

• Do not wish to provide

Make your pitch!

The NSF/TIP Directorate would like to bring in reviewers with new voices and diverse, cross-sector perspectives.

Please share with us why would you like to be a NSF reviewer? Feel free to include your previous work or volunteer experience that is relevant to or aligned with the goals and mission of the TIP programs in which you are interested in serving as a reviewer. You could also include any previous work you have done in a certain topic area, technology, geographical region, and/or community.