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APPENDIX B SURVEY OF EARNED DOCTORATES (Conducted by the National Research Council under the sponsorship of the National Science Foundation, the Department of Education, the National Institutes of Health, and the National Endowment for the Humanities.) This annual survey of new recipients of Ph.D. or equivalent research doctorates in all fields of learning contains information describing their demographic characteristics, educational background, graduate training, and postgraduation plans. The source file includes nearly complete data from all 1958-81 doctorate recipients and partial information for all 1920-57 doctoral graduates. 228

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This form is to be returned to the GRADUATE DEAN, for forwarding to .................... Please print or type. A. Name in full: . 229 SURVEY OF EARNED DOCTORATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... ...... . (Last Name) (First Name) (Middle Name) Cross Reference: Maiden name or former name legally changed ............................. B. Permanent address through which you could always be reached: (Care of, if applicable) .............................................. . (Number) (Street) ........................................ (State) C. U.S. Social Security Number: _ - - D. Date of birth: (4145) Sex: F. G. Marital statu Citizenship: . . . . . . . . . . . . . . . . . . . (Month) (Day) 1 O Male ;: ~ O Married 0 O U.S. native 1 0 U.S. naturalized ................................ .... .... .. . .. (City) .................................................................... (Zip Code) (Or Country if not U.S.) ........ Place of birth: (Year) (46~7) (State) (Or Country if not U.S.) 2 O Female 2 0 Not married (including widowed, divorced) 2 O Non U.S., Immigrant (Permanent Resident) 3 0 Non-U.S., Non-Immigrant (Temporary Resident) If Non-U.S., indicate country of present citizenship ............................ NSF Form 558 1977 OMB loo. 99-R0290 Approval Expires June 30, 1979 .... Board on Human-Resource Data and Analyses Commission on Human Resources National Research Council 2101 Constitution Avenue, Washington, D. C. 20418 . (9-30) ................. (31) ( 32-40 ) (48) (49) (50) (s'-s2 ) H. Racial or ethnic group: (Check all that apply.) A person having origins in 0 O American Indian or Alaskan Native Any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition. 1 0 Asian or Pacific Islander . any of the original peoples of tlie Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands, and Samoa. . any of the black racial groups of Africa. . any of the original peoples of Europe, North Africa, or the Middle East. . . . Mexican, Puerto Rican, Central or South American, or other Spanish culture or origins, regardless of race. (53 5s) I. Number of dependents: Do not include yourself. (Dependent = someone receiving at least one half of his or her support from you) (56) J. U.S. veteran status: 0 0 Veteran 1 0 On active duty 2 0 Non-veteran or not applicable (en through tribal affiliation or commune recoin 2 O Black, not of Hispanic Origin ...... 3 O White, not of Hispanic Origin ...... 4 O Hispanic ........................ K. High school last attended: .............. (School Name) Year of graduation from high school: ..... L. List in the table below all collegiate and graduate institution elude your doctoral institution as the last entry. Institution Name Location .................................................................. (58-59) (City) (State) (6~61 s you have attended including 2-year colleges. List chronologically, and in- Major Field | Minor Use Specialties List Degree (if any) Granted Yr M. Enter below the title of your doctoral dissertation and the most appropriate classification number and field. If a project report or a musical or literary composition (not a dissertation) is a degree requirement, please check box. O Title Classify using Specialties List Number Name of field N. Name the department (or interdisciplinary committee, center, institute, etc.) and school or college of the university which supervised your doctoral program: ....... (Depa rtment/ I nstitute/ Comm i/tee/Program) (School) O. Name of your dissertation adviser: .................................................................................. (Last Name) (First Name) (Middle Initial) continued on next page (44)

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230 SURVEY OF EARNED DOCTORATES, Cont. P. Please enter a "1" beside your primary source of support during graduate study. Enter a "2" beside your secondary source of support dur- ing graduate study. Check all other sources from which support was received. 58 NSF Fellowship 66 GI Bill 72 Research Assistantship 76 Spouse's earnings 59- NSF Traineeship 67 Other Federal support 73 Educational fund of 77 Family contribu- 60_NIH Fellowship (specify) industrial or tions 61 NIH Traineeship 68 Woodrow Wilson Fellowship business firm 78 Loans (NDSL 62 NDEA Fellowship 69 Other U.S. national fellowship 74 Other institutional direct) 63_Other HEW funds (specify) 79- Other loans 64 AEC/ERDA (specify) ...................... 80 Other (specify) Fellowship 70 University Fellowship 75_Own earnings ............... 65 NASA Traineeship 71 Teaching Assistantship Q. Please check the space which most fully describes your status during the year immediately preceding the doctorate. 0 O Held fellowship 1 O Held assistantship 2 O Held own research grant 3 O Not employed 4 O Part-time employed 5 O College or university, teaching Full-time 6 O College or university, non-teaching Employed in: 7 O Elcm. or sec. school, teaching (Other than 8 O Elem. or sec. school, non-teaching 0, l, 2) g O Industry or business (11) O Other (specify) (12) O Any other (specify) (9) R. How many years (full-time equivalent basis) of professional work experience did you have prior to the doctorate? (include assistantships as professional experience) ................................... .......... ( 10-1 ~ ) POSTGR`4DUATION:PIJ`NS : : ~~ ~ ~ ~ ~ :~ ;~ ~ :~ ~~ ;~ ~ :? ~ at S. How well defined are your postgraduat~on plans? 0 O Have signed contract or made definite commitment 1 0 Am negotiating with a specific organization, or more than one 2 O Am seeking appointment but have no specific prospects 3 C1 Other (specify) (12) T. What are your immediate postgraduation plans? 0 O Postdoctoral fellowship? 1 O Postdoctoral research associateship? 2 O Traineeship? 3 O Other study (specify) ................. 4 O Employment (other than 0, 1, 2, 3) 5 O Military service? 5 O Other (specify) (~3) ) U. If you plan to be on a postdoctoral fellowship, associateship, traineeship or other study What will be the field of your postdoctoral study? Classify using Specialties List. Number Field ago to f Item"U" . . . Go to Item "V" . . . . . . . . . . . . . . . . . . . . . . . . . . What will be the primary source of support? 0 O U.S. Government 1 O College or university 2 O Private foundation 3 O Nonprofit, other than private foundation 4~O Other (specify) ....(14-16) ............................................. ( 17) 6 O Unknown Go to Item "W" W. What is the name and address of the organization with which you will be associated? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name of Organization) your mother none o V. If you plan to be employed, enter military service, or other What will be the type of employer? 0 O 4-year college or university other than medical school 1 O Medical school 2 O Jr. or community college 3 O Elem. or sec. school 4 O Foreign government 5 O U.S. Federal government 6 O U.S. state government 7 O U.S. local government 8 O Nonprofit organization 9 O Industry or business ( 11 ) O Self-employed (12) O Other (specify) (ha) Indicate Diary work activity with "1" in appropriate box; seco~r~lury work activity (if any) with "2" in appropriate box. 0 O Research and development 1 O Teaching 2 O Administration 3 O Professional services to individuals 5 O Other (snecifY)................. In what field will you be working? Please enter number from Specialties List (2~-23) Go to Item "W" (City, Statej (O; Country if not US.) (2i29; ~"~ ~~ . ~~ ', ~~ ' ,: : X. Please indicate, by circling the highest grade attained, the education of your father: none 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 MA, MD PhD Postdoctoral (so) Elementary school High school College Graduate 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 MA, MD PhD Postdoctoral (31, _ . . _ 1 2 ~ 4 5 6 7 8 9 (11) Signature Date completed , .............. (32-34 )