San Gorgonio Section Members Questionnaire
Name: email: phone #:
ACS member yes __ no__ SGS member yes__ no__
Work affiliation Industrial __ Academic __ other __
Institution Name ____________________________________
Have you participated in any of the SGS activities during the last 12 months? yes__ no__
If you answer is no, could you briefly explain your reasons?
What type of presentation or function would you most likely be willing to attend?
Would you be willing to host a meeting at your institution? yes__ no__
At your institution are there any speakers that you would like to recommend? yes__ no__
Are you willing to volunteer your time to the SGS? yes__ no__
Program committee Industry__ Academic__
Project SEED Mentor __
Thank you for your time in answering this questionnaire,
San Gorgonio Section