ASA Directory of Minority Statisticians

Thank you for visiting our on-line Minority demographics questionnaire section. This questionnaire should take no longer than five minutes to complete. We appreciate your assistance and we look forward to better serving you.

Note: Fields in red are required, but please fill in everything you can.

Informed Consent:
  Yes, please include my information in the Minorities in Statistics Online Directory.
  I do not want any personal information listed in the Minorities in Statistics Online Directory, but I am willing to be included in counts for tables and figures.
  I do not want any information listed in the Minorities in Statistics Online Directory, and I am not willing to be included in counts.
I would like to be offered (by email) the following opportunities for service (please check all that apply):
to serve on panels or advisory committees of Federal Agencies such as NSF, NIH, CDC, HRSA, FDA, etc . . .
to serve on panels or committees to review proposals for grants, agreements, fellowship awards, etc . . .
to provide editorial review of papers/reports for journals
to serve on committees for statistical organizations such as the ASA, Biometric Society, etc . . .
I would like to receive job announcements by email
Prefix:
First:  
Middle:  
Last:  
Suffix:  
What is your employment status?
What is your employment category?
What is your job title?
What is your place of employment?
Organization:
Department:
Address:
City:
State/Province:
Zip:
Country:
Work Phone:
Fax:
Email:  
web site:
What is your highest degree?
What are your major statistical activities?

1:
2:

What are your fields of application?

1:     Other:
2:     Other:
3:     Other:

What are your areas of specialization?

1:     Other:
2:     Other:
3:     Other:

Are you an ASA member?

If yes, do you belong to any ASA sections? If so, choose the applicable sections:
  BIOM   EDUC   HPSS
  SBSS   NPAR   BIOP
  ENVR   MKTG   SOC
  B&E   EPI   SPES
  SIS   COMP   GOVT
  Q&P   SRMS   CNSL
  GRPH

   RISK

   TSHS
Ethnicity: Are you Hispanic or Latino?
What is your race?
  American Indian or Alaska Native
  Asian
  Black, African American
  Decline To Answer
  Hispanic/Latino/Latina
  Native Hawaiian or Pacific Islander
  Other
  White
What is your gender?
What is your year of birth?