PERSONAL INFORMATION
First Name:
Middle Initial:
Last (Family) Name:
Home or Work Phone:
(include appropriate codes: country, area/city, etc.)
Cell Phone:
(include appropriate codes: country, area/city, etc.)
E-mail:
Mailing Address:
Web Site URL:
Learned of search:
(please specify how you heard/learned about this search)
RESEARCH INTERESTS
Please select the research area in which you are most interested in working:
Astrophysical Detector Development
Atomic Physics
Condensed Matter Physics
Gravitational Physics
High Energy Astrophysics
High Energy Physics
Infrared and Sub-millimeter Astronomy
Low Energy Particle Physics
Microwave Background Observations
Neurobiology
Nuclear Physics
Quantum Optics
Radio Astronomy
Solar Physics
Surface Physics
Ultraviolet Astrophysics
Please select the research area in which you are secondarily interested in working:
Astrophysical Detector Development
Atomic Physics
Condensed Matter Physics
Gravitational Physics
High Energy Astrophysics
High Energy Physics
Infrared and Sub-millimeter Astronomy
Low Energy Particle Physics
Microwave Background Observations
Neurobiology
Nuclear Physics
Quantum Optics
Radio Astronomy
Solar Physics
Surface Physics
Ultraviolet Astrophysics
Provide a brief description of your research interests (approximately 50 words or less ):
ACADEMIC/EMPLOYMENT HISTORY
CURRENT POSITION
Employer:
Position Title:
EDUCATION
Year PhD was Received:
(yyyy)
or
Date PhD is Expected:
(mm/yyyy)
University where PhD was (will be) received:
Name of PhD Advisor(s):
REFERENCES
Please provide the names of at least three references from whom you will be requesting letters, select the appropriate Salutation, and provide the institution and email address for each.
(1) Salutation:
Please Select
Professor
Dr.
Ms.
Mr.
Reference 1 Name (First Last):
Institution (name, not address):
Reference 1 Email Address:
(2) Salutation:
Please Select
Professor
Dr.
Ms.
Mr.
Reference 2 Name (First Last):
Institution (name, not address):
Reference 2 Email Address:
(3) Salutation:
Please Select
Professor
Dr.
Ms.
Mr.
Reference 3 Name (First Last):
Institution (name, not address):
Reference 3 Email Address:
(4) Salutation:
Please Select
Professor
Dr.
Ms.
Mr.
Reference 4 Name (First Last):
Institution (name, not address):
Reference 4 Email Address:
(5) Salutation:
Please Select
Professor
Dr.
Ms.
Mr.
Reference 5 Name (First Last):
Institution (name, not address):
Reference 5 Email Address:
(6) Salutation:
Please Select
Professor
Dr.
Ms.
Mr.
Reference 6 Name (First Last):
Institution (name, not address):
Reference 6 Email Address:
Gender:
Male
Female
Ethnicity:
Please check the category with which you most closely identify.
Caucasian (not of Hispanic origin)
All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.
Black (not of Hispanic origin)
All persons having origins in any of the racial groups of Africa.
Asian American or Pacific Islander
All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands and Samoa.
Hispanic
All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
American Indian or Alaskan Native
All persons having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition