Welcome to the HSGC Longitudinal Tracking System. NASA requires that we gather data on the education and employment history of current and former participants in our programs. This enables us to improve our programs and assists us in seeking new funding to conduct additional programs. The information that you provide here will be kept private and not shared with anyone except NASA, our sponsor.

Please fill in your information. Fields marked with * are required.
If you have filled out this form before and are updating our records, just fill in your name, contact information, and the relevant sections where you are adding or updating information. Thank you.

Name (First Middle Last):*

Gender:    Male       Female

Street Address:*

City:*       State:*       ZipCode:*

Phone:*

E-mail:*

What is the best way to contact you?*  email       phone       mail

Race:
    Alaska Native 
    American Indian 
    Black or African American 
    Asian 
    Hispanic 
    Pacific Islander 
    Caucasian 
    Native Hawaiian 
    Other 

Ethnicity:
    Hispanic/Latino 
    Other 

Citizenship:
    US Citizen 
    Non US Citizen 

Physical Disability:
    Yes 
    No 

Name of campus while a fellow or trainee:*

When will/did you get your undergraduate degree?*
    Indicate Year:
    Semester:
    Campus:
    Major:

If you are still a student, what is your current academic standing?
    Undergraduate 
    Master's Candidate 
    PhD Candidate 
Other post-baccalaureate program 

If you are in a graduate program, please tell us where. 

If you are in a graduate program, please tell us in which field. 

What is your educational goal?
    Associate's
    Bachelor's
    Second Bachelor's
    Master's
    Second Master's
    PhD
    Post-Doctoral
    other    

Not in school
If you are not a student, what is your current occupation and who is your employer?

Employment History:
    List Employer, Position, Dates, and please indicate if job was space related or STEM related.
    (We provide three spaces here for you to list information about three past positions.)

*If your participation in the Space Grant Fellowship/Traineeship program helped you reach your educational and professional career goals, please tell us how. If not, please explain.*

If you have published any of your Fellowship/Traineeship work, please give us the details of authors, year, title, publication, and page numbers.

Use this space to list achievements or academic awards you have received since completing your Space Grant Fellowship/Traineeship.

If you have any other comments about Space Grant programs, please write them here.