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2019 IUPAC U.S. Young Observer Program Application

Please answer the questions below and then complete the application form. Please note that fields with asterisks, including attaching a C.V., are required.

1. Please answer the below eligibility questions. Note that you must answer "yes" to both questions in order to be eligible. *This question is required.

Space Cell	Yes	No
Are you under 45 years of age?	Are you under 45 years of age?: Yes	Are you under 45 years of age?: No
Are you a U.S. citizen or permanent resident?	Are you a U.S. citizen or permanent resident?: Yes	Are you a U.S. citizen or permanent resident?: No

If you work in industry or government, please note: There have been cases in the past where Young Observers from industry and government have been unable to accept the travel fellowship due to restrictions within their organizations. They were still able to participate in the program, but their funding was provided by their employer. As you apply for the Young Observer program, please explore with your employer any restrictions you may have on accepting a fellowship grant from the National Academies. Please email us at IUPACYO@nas.edu if you have any questions. *This question is required.

I have read this statement

Please specify: *This question is required.

Contact Information

First Name *This question is required.

Last Name *This question is required.

Job Title

Institution/Company *This question is required.

Department

Street Address *This question is required.

City *This question is required.

State *This question is required.

Postal Code *This question is required.

Country

Phone Number

Fax Number

Email Address *This question is required.

Fields of Interest *This question is required.

Date of Birth (MM/DD/YYYY) *This question is required.

Attach Curriculum Vitae (two-page maximum) *This question is required.

File: {{filename}} delete

Briefly answer the following questions:

2. How would participation as a Young Observer at the IUPAC General Assembly further your professional development? Please limit your response to no more than 250 words. *This question is required.

3. In which IUPAC Divisions, Committees or projects would you like to participate? Briefly indicate why. If you have ideas on how you could stay involved in IUPAC after the General Assembly and Congress, please indicate so. *This question is required.

4. Have you recently been involved with any international collaborative activities? Describe briefly. If not, describe your interest in international collaboration. *This question is required.

5. Have you submitted (or do you plan to submit) an abstract for presentation at the IUPAC Congress? If so, to which session? Attach abstract if available.

Abstract (10MB max.)

File: {{filename}} delete

6. If you are a former YO applying for a second experience, please describe how you have remained involved in IUPAC since your YO experience.

7. Please let us know how you heard about the Young Observer Program. Select all that apply. *This question is required.

Colleague or friend
IUPAC
Previous Young Observer
Email announcement (please note source) Please enter an 'other' value for this selection.
Social media (please specify) Please enter an 'other' value for this selection.
Professional society (please specify) Please enter an 'other' value for this selection.
Other (please describe) Please enter an 'other' value for this selection.

8. For statistical purposes only, please provide your race. Select all that are applicable. *This question is required.

White, non-Hispanic
Asian/Pacific Islander
Black, non-Hispanic
Hispanic
American Indian/Alaska Native
Prefer not to answer
Other ethnicity (please specify) Please enter an 'other' value for this selection.

9. For statistical purposes only, please indicate which gender you identify with: *This question is required.

Male
Female
Other
Prefer not to answer