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* 1. First Name

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* 2. Last Name

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* 3. Title/Position

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* 4. Institution

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* 5. Division/Department

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* 6. Work Email

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* 7. Work Phone Number

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* 8. Please check all days that you plan to attend.

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* 9. List below at least one and at most five EHR programs that you may be interested to learn about during the workshop. Please enter each program on a separate line and use the program abbreviation if applicable.
A list of current EHR programs can be found here:
https://nsf.gov/funding/programs.jsp?org=EHR

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* 10. Please list any questions you may have about NSF's Merit Review Process.
Information on the Merit Review Process can be found here:
https://nsf.gov/bfa/dias/policy/merit_review/

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* 11. How important are opportunities for the following in your decision to attend this workshop?

  Unimportant Slightly important Somewhat Important Very Important
learning about NSF in general (e.g. its structure and operation)
learning about the programs and funding opportunities offered by NSF/EHR
learning how to write/submit (more) competitive proposals to NSF
learning about NSF's merit review process
meeting and networking with colleagues and NSF staff

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* 12. Select any of these research areas that are of interest to your work

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* 13. What is the focus of your educational work?

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* 14. If you are interested in forming professional or research partnerships through this event, which kind(s) of potential partnerships are you interested in forming?

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* 15. Please describe any additional topics you would like to learn more about during the workshop.

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* 16. Would you like to request any accommodations for accessibilty at this workshop?

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* 17. May we include you in a list of participants for event materials?

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* 18. All participants will receive a workshop evaluation survey at the conclusion of the event.
May we contact you with one additional follow-up survey in the months following the event?

By attending this event, you agree to appear in still photographs.

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