Deadline to complete form: October 7, 2022 by 5 PM ET.

The OMB control number for this collection is 3145-0058. Public reporting burden for this collection of information is estimated to average 5-10 minutes per response, including the time for reviewing instructions.

To learn more about NSF Engines program, click here.

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* 1. First Name

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* 2. Last Name

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* 3. Organization Name

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* 4. Organization Type

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* 5. Occupation

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* 6. What state do you reside in?

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* 7. Email

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* 8. Have you ever served as an NSF Reviewer before? *
This is not a requirement to be an NSF Engines reviewer but we may ask you to join a brief training session on September 20, 2022 to prepare for the NSF Merit Review process.

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* 9. URL providing additional details about yourself (can be a LinkedIn profile)

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* 10. What is your gender?

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* 11. Which race best describes you (check one or more that apply)

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* 12. Which ethnicity best describes you? (Please choose only one.)

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 NSF Regional Innovation Engines program. Other NSF programs requesting names of potential reviewers or specialists in particular fields may also be given information from this form. 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.

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