IAAMCS Fellowship Writing Workshop Series Sign-Up Form

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Before you get started, please note that you will be asked to share your journey to this point and where you want to go next (250-500 words). To save time, you might want to have something pre-existing ready to copy and paste.

Email *

Last Name *

First or Preferred Name *

Institution *

Phone Number *

Please Choose the Option that Best Describes You
*

Undergraduate Student

Master's Student

Doctoral Student

Other:

What do you want to gain from the Fellowship Writing Workshop Series?
*

In 250-500 words, share your journey to this point and where you want to go next.
*

What sector related to computing careers are you interested in pursuing?
*

Academia

Government agencies

Tech/Private Industry

Entrepreneurship

Other:

Required

Please share some more details about the selection above.
*

Please specify any specific fields you are interested in (e.g. machine learning, artificial intelligence, data science, etc.)
*

Gender: Please specify your gender.

*If other, please specify (optional)
*

Female

Male

Non-binary and/or gender queer

Prefer not to answer

Other:

Do you identify as transgender?
*

Yes

Prefer not to answer

Race/Ethnicity: How do You Identify?
*

Which of the following best describes you? Please select all that apply

*If other, please specify (optional)
*

Black or African American

American Indian or Alaskan Native

Asian or Asian American

Hispanic or Latino/a/x

Middle Eastern or Northern African

Native Hawaiian or Other Pacific Islander

White

Other:

Required

Age: What is your age?

18-24 years old

25-34 years old

35-44 years old

45-54 years old

55-64 years old

65-74 years old

75 years or older

Clear selection

Are you a first generation college student (answer yes if none of your parents/guardians completed a bachelor's degree)?
*

Yes

Please indicate if you are a U.S. citizen.
*

Yes

Do you identify as having a disability or other chronic condition?
*

Yes

Prefer not to answer

How would you describe your disability or chronic condition?

*If other, please specify (optional)

Attention deficit

Autism

Blind or visually impaired

Deaf or hard of hearing

Health-related disability

Learning disability

Mental health condition

Mobility-related disability

Speech-related disability

Other:

What accommodations, if any, would make it easier for you to participate in the IAAMCS alliance activities (for example, automatic captions during webinars, ensuring that all publications are accessible for screen readers)?

Is English your primary language?
*

Yes

Which of the following best describes your personal income last year?
*

$0-$9,999

$10,000-$24,999

$25,000-$49,999

$50,000-$74,999

$75,000-$99,999

$100,000-$149,999

$150,000+

Prefer not to answer

Are you currently receiving, or have you ever been eligible for a Federal Pell Grant?
*

Yes

I'm not sure

Prefer not to answer

What is your current highest level of education?

*If other, please specify (optional)
*

Some college

Associate’s degree

Bachelor’s degree

Master's degree

Professional degree

Doctorate degree

Other:

IAAMCS offers more than fellowship writing workshops, it is a community. Please check the box next to the activities in which you engage(d) or want more information.
*

Paired Mentoring Program

Future Faculty & Research Scientist Mentoring Program

Affiliated Networking Events

Build Social Media Presence

Original Mentoring Content Development

Black CS Student Database

Annual Report on the State of Blacks in Computing

Core Research

Development of National Guidelines

None of the above

Other:

Required

The IAAMCS community extends beyond the most recent cycle of the grant. Would you please indicate if you engaged in any of the IAAMCS activities offered before October 1, 2022?
*

Collaborative Research Experiences for Undergraduates (CREU)

Distinguished Fellowship Writing Workshop

Distributed Research Experiences for Undergraduates (DREU)

Future Faculty and Research Scientist Mentoring Program

IAAMCS Distinguished Lecture Series (DLS)

IAAMCS MentorNet

Modern Figures Podcast

Morehouse-Spelman Virtual Mentoring Program

National Society for Blacks in Computing (NSBC) Conference

None of the above

Other:

Required

Pre-Assessment Questions

I am confident in my ability to secure graduate school fellowships.
*

Strongly Disagree

Strongly Agree

I am confident in my career goals beyond undergraduate school.

Strongly Disagree

Strongly Agree

I am knowledgeable about preparing for an academic/teaching career.

Strongly Disagree

Strongly Agree

I am knowledgeable about the graduate school application process.

Strongly Disagree

Strongly Agree

Send me a copy of my responses.

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