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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. 224
225 SURVEY OF EARNED DOCTORATES This form is to be retr~inccl t<, the GRADUATE DEAN, for forwarding to ... Please print or type. NSF Form 558 1977 OMB No. 99-R0290 Approval Expires June 30, 1979 ....... I3o;`r~l on [{uman-Resource Data and Analyses Commission on Human Resources National Research Council ~101 Constitution Avenue, Washington, D. C. 20418 A. Name in full: (9~30) (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) , .......................................... . (city) ............................. ................................................................................... .. . .. .. . . . .. . (state) (zip Code) (Or Country if not U.S.) C. U.S. Social Security Number:- D. Date of birth: . (41-45 ) E. Sex: F. Marital status: G. Citizenship: (Month) 1 O Male 1 O Married O O U.S. native 1 O U.S. naturalized ................ Place of birth: {Day) (Year) (46~7) (State) (Or Country if not U.S.) 2 O Female 2 O Not married (including widowed, divorced) 2 O Non U.S., Immigrant (Permanent Resident) 3 O Non-U.S., Non-Immigrant (Temporary Resident) If Non-U.S., indicate country of present citizenship ................................................ H. Racial or ethnic group: (Check all that apply.) ~ng origins in .................... (31) ( 32-40 ) (48) (49) (50) (5] -52 ) U U American Indian or Alaskan Native . ~h~i~s of North America and who maintain c'IIt',rnl irlentifir~tinn through tribal affiliation or community recognition. 1 0 Asian or Pacific Islander . any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent. or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands, and Samoa. 2 O Black, not of Hispanic Origin . any of the black racial groups of Africa. 3 O White, not of Hispanic Origin . any of the original peoples of Europe, North Africa, or the Middle East. 4 O Hispanic . Mexican, Puerto Rican, Central or South American. or other Spanish culture or origins. regardless of race. !. Number of dependents: Do not include yourself. (Dependent = someone receiving' at Act onto Elf of his sir her c''nn~rt from V^~1\ J. U.S. veteran status: 0 O Veteran 1 O On active duty NEDI*~ l ~~''~ - ~ ~ it, K. High school last attended: (School Name) (City) (State) Year of graduation from high school: . ( 53-s5) ~ ~ ~ _ ~ ~ ~ ~ ~ ~ · - - - - ( ) 2 0 Non-veteran or not applicable (57) (60-61) L. List in the table below all collegiate and graduate institutions you have attended including 2-year colleges. List chronologically, and in- clude your doctoral institution as the last entry. Institution Name . Major Field I Minor Degree (if any) __ . Use Specialties List Title of Degree _ Number Gral Ted Mo vl _ 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/ l nstitute/ Comm iKee/Program) (School) O. Name of your dissertation adviser: ..... .......... .................................................................. (Last Name) (First Name) (Middle initial) continued on next page (44)
226 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 Spouses 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 bossiness firm 7g I oans (NDSL 62 NDEA Fellowship 69_Other U.S. nationalfello~ship 74 Otherinstit~tional direct) 63 Other HEW fiends (specify) 79 Other loans 64 AEC/ERDA (specify) ...................... 80_Other (specify) Fel lowship 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 0 Held fellowship 1 0 Held assistantship 2 0 Held own research grant 3 O Not employed 4 O Part-time employed 5 0 College or university teaching Full-time 6 0 College or university non-tcaching Employed in: 7 O Elem. or sec. school teaching (Other than 8 O Elem. or sec. school non-teaching 0, 1, 2) 9 O Industry or business (11) 0 Other (specify) (12) Cl 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) (1o-t l ) . . . r POSTGI?ADUATION PENS :: S. How well defined are your postgraduation plans? V. 0 O Have signed contract or made definite comn~itment 1 0 Am negotiating with a specific organi;cation, or more than one 2 O Am seeking appointment but have no specific prospects T. 3 O Other (specify) ..................... What are your immediate postgraduation plans? 0 O Postdoctoral fellowship? 1 O Postdoctoral research associateship? 2 O Traineeship? , 3 O Other study (specify) J 4 O Employment (other than O. 1, 2, 3) ~ Go to 5 O Military service? ~ Item "V" 6 O Other (specify ) ( ~ 3 ) J 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 ..... (12) . . . ... . . . . . . . . . . . . . . . . .. . . 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 ~ 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) X. Please indicate, by circling the highest grade attained, the education of If you plan to be employed, enter military service, or other What will be the type of employer? 0 0 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 p~i,''<`ry work activity with "1" in appropriate box; seco'~`lc~ry, work activity (if any) with "2" in appropriate box. 0 0 Research and development 1 O Teaching 2 O Administration 3 0 Professional services to individuals 5 O Other (specify) (~9-20) In what field.will you be working? Please enter number front Specialties List (2~-23) Go to Item "W" . . . . . . . . . . . . .. .. .. . . . . . . . . . . . . ... ... .. .. .. (City, State) (Or Country if not U.S.) (24-29) your father: none 1 2 3 4 5 6 7 8 9 10 11 12 . 1 2 3 4 MA, MD PhD Postdoctoral (30) Elementary school High school College Graduate your mother none 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 MA MD PhD Postdoctoral (31 0 1 2 3 4 5 6 7 8 9 (11) Signature Date completed .............. (32-34 )
