Who are you?
Your First Name: 
Your Middle Name: 
Your Last Name: 


Your address?
Institution: 
Department:  
Address Line #1: 
Address Line #2: 
Address Line #3: 
Daytime Phone:  
    
Cellphone: 


Your E-Locations?

E-Mail: 
Secondary E-Mail:   

Web page: 


What degrees have you completed?

Bachelors: 
  Area:  
  Institution: 
  Year Completed: 

Masters:
  Area:   
  Institution: 
  Year Completed: 

Ph.D.:
  Area:    
  Institution: 
  Year Completed: 

 Other:   
 Area:   
 Institution: 
 Year Completed: 


Where are you in your current program of study?

Area:  

 Year 1, M.S.
 Year 2, M.S.
 Year 3, M.S.
 Year 4, M.S.
 5+ Years, M.S.
 Year 1, Ph.D.
 Year 2, Ph.D.
 Year 3, Ph.D.
 Year 4, Ph.D.
 5+ Years, Ph.D.
 Other: 


Who will write a letter of recommendation supporting your application?

Title: 
Professor
Associate Professor
Assistant Professor
Other

Name: 
Phone: 





Some optional information which we are required 
to track, since this is a federally funded program.  
You are not obligated to answer these questions:


Birthdate: 
 (format mm/dd/yy)
Gender:  
  M F


Ethnicity:
 




Are you a U.S. Citizen
Permanent Resident
non-U.S.Citizen ?


If not a U.S. citizen or permanent resident, please list country of citizenship: 

Do you have a passport that will
be valid at least six months beyond the conclusion of the
workshop?   



Y N  
           


What is your background in Algorithmic Aspects of Information Fusion



Little or none (e.g. attended a few talks)
One or more courses
Other: 





1. Have you had coursework that includes includes modeling, simulation, and visualization techniques? 
yes
no


2. What continuous mathematics courses  have you completed?
Calculus and multivariate calculus  yes no
Differential equation and different calculus  yes no
Real analysis yes no
Others: 

3. What discrete mathematics courses have you completed?
Combinatorics and graph theoryyes no
Discrete probability and optimization yes no
Abstract and linear algebrayes no
Others: 


4. What statistics courses have you completed?
Basic statisticsyes no
Inference and hypothesis testing  yes no
Stochastic processes yes no
Others: 

5. What computer science courses have you completed?
Basic computer science with  programming(e.g.: C++, Java ) yes no
Algorithm and computation yes no
Data bases  yes no
Others: 



6. What information science courses have you completed?
Machine learning and data mining yes no
Information fusion and knowledge discovery  yes no
Informatics and analysis  yes no
Others: 


7. What applied informatics courses have you completed?
Biological and health informaticsyes no
Financial informatics and business analytics  yes no
Ecological and environmental informatics  yes no
Others: 


8. What information fusion courses have you completed?
Ensemble method  and semi-supervised learning yes no
Sensor data fusion yes no
Feature selection and combinationyesno
Decision making and fusionyes no
Combinatorial fusion and rank aggregateyesno
Others: 


9. List of other relevant STEM(science, technology, engineering and mathematics) courses
   you have completed.

     1: 
     2: 
     3: 
     4: 
     5: 
     6: 
     7: 
     8: 
     9: 
     10:
     11:
     12:




What is your proficiency with computational and mathematical modeling and data mining software?

Matlab
None Beginner Intermediate Advanced

Mathematica
None Beginner Intermediate Advanced

Algorithmica
None Beginner Intermediate Advanced 

        SAS
None Beginner Intermediate Advanced

        Random Forests
None Beginner Intermediate Advanced

                SPSS
 None Beginner Intermediate Advanced
Other:
 





Please indicate your preferences for covering the workshop costs 
(travel, housing, meals, and registration). 

Please indicate whether you need full funding or whether you have 
other sources of funding. If you have other sources of funding that might cover part 
of the cost please indicate below how much they might cover. Estimates are acceptable

 I would like to be considered for funding through the program, but will still attend the workshop if I receive no funding.
 I will only be able to attend the workshop if I receive funding through the program to cover costs.
 I would like to be considered for funding through the program, but will attend the workshop if I only receive partial funding.
 I am only applying for waiver of registration fees.
 Estimate of costs to be covered by other sources