Figure 1 page A 



Section 6 - Availability. Geographic Experience and Other Factors 



to. DOES YOUR EMPLOYBR HAVE A POLICY WHICH LIMITS YOUR CONSULTING TIME? i[ ] YES z\ 



IF YES, OIVE CEILING IN DAYS PER MONTH: [ ] 



NO ][ ) NOT APPLICABLE 



21. IF YOUR ANSWER TO QUKSTION 20 WAS YES, DOES THIS APPLY TO PUBLIC SERVICE (PRO BONO) WORK ALSO? i[ ]yeS l[ ] NO ^ 



12. HOW MANY DAYS WOULD YOU BE ABLE TO WORK IN IS?]? 



DURING THE ACADEMIC YEAR? 

 DURING THE SUMMER? 



( 



] DAYS PER MONTH 

 ] DAYS PER MONTH 



It. WOULD YOU BE WILLING TO ACCEPT A LEADERSHIP ROLE (SUPERVISING THE WORK OF OTHER PROFESSIONALS) 

 IN A CONSULTING SITUATION? l[ )yKS 



24. indicate 

 United St 



BELOW the time (IN YEARS) that you have spent in EACH REGION SINCE RECEIVING YOUR BACHELOR'S OEORBB : 



lOi. 

 10/ 



Pacific states 

 Rocky Mountain 

 Southwest 

 North Central 

 South Central 

 Northeast 

 Middle Atlantic 



Other (coht. 1 



114 



Jib 



Jio 



J17 

 118 

 ]19 

 I 20 



Canada, eastern 

 Canada, western 

 Canada, northern 

 Europe, eastern 

 Europe, western 

 South America 

 Other (specify) 



I ■ I I ' ' ' I 



i(6Q-6al 



at. INDICATE WITH A CIRCLE, IN THE ABOVE LIST, THOSE REGIONS IN WHICH YOU HAVE THE MOST EXPERIENCE IN YOUR 



RESCARCH ACTIVITIES. 



. INDICATE YOUR LANGUAGE 



PROFICIENCY 



NAME OF LANGUAGE(»| 



CAN PREPARE 



AND DELIVER 

 LECTURES 



•LUBNTL* 



HAVE FACILITY 

 TO TRANSLATE 



TECHNICAL 

 JOURNALS 



CAN READ 



TECHNICAL 



ARTICLES 



FOR OWN USE 



WITH 



OiPFI- 



CULTV 



SOME 



KNOWLECDGK 



BUT can't 



use AS A 

 MEDIUM OF 

 COMMUNI- 

 CATION ^ 



French 

 Gernijn 

 SpanisM 



, Russian 

 Chinese 

 Japanese 



, Portuguese 



, itattan 



, English 



, other 



14(3S-i6)L_LJ 

 ( 37-38) ULJ 



14 A Y 



(40-4j)LLJ 1 I I 



(t4.17)l_LJ LJ-J 

 (4B-i..)l-l-I i-LJ 



(s2-55}L_LJ L-LJ 



(56-5»)l_LJ I 1 I 



4(69-70)1. i_l 



(»-7z)L_LJ 

 (7i-7a)l_LJ 



L P 



4(7^ft) LJ LJ 

 (77-78) L J LJ 

 ( 79-80) LJ LJ 



17. PLEASE ATTACH A VITAE FOR TIE's FILES. THIS INFORMATION WILL ONLY BE FURNISHED TO GROUPS INDICATED IN QUESTION IS. 



MAIL QUESTIONNAIRE TO: TIE, Suite 3200, 995 L'Enfant Plaza, WASHINGTON, D.C. 20024 



