International Research Survey

1. Name:

2. Gender:

Male Female

3. College:

4. Department:

5. UMC:

6. Phone:

7. Email:

8. Native Language:

9. Other Languages:

10. Areas of Research Expertise please use key words):

11. Areas of Technical Assistance Expertise (please use key words):

12. Previous International Research/Technical Assistance Experience:

Yes No

13. Country/Countries Where Project(s) was/were Performed:

14. Are you interested in being involved with international projects?

Yes No

15. Are you currently involved with any international projects?

Yes No

International Research

Old Main Room 159, UMC 1450
Logan, UT 84332-1450
phone: 435.797.1180
fax: 435.797.1367
vp.research@usu.edu