newrecord

IMPORTANT: BE SURE TO COMPLETE EACH FIELD MARKED WITH AN *
DO NOT PRESS THE “SUBMIT” BUTTON AT THE BOTTOM OF THE PAGE UNTIL YOU HAVE COMPLETED THE ENTIRE SURVEY. USE THE “TAB” KEY
(NOT THE “ENTER” KEY) TO MOVE BETWEEN FIELDS.

ID Number*

Three digit number

EMAIL*

Today’s Date*

Use the format to rhe right

YYYY-MM-DD

Given Name

Middle Name

Family NAME

Position

Organization

Address Line 1

Address Line 2

Address Line 3

City

State, Province, Prefecture

Country

Postal Code

Telephone

Fax

Cell Phone

Web Page

Highest earned degree

Year of Highest Degree

Gender

Birth Year

Birth Country

How many, if any, years have you spent outside of your birth country?

What country have you spent the most time living in?


	List your most recent or important intercultural publications


	First Publication:


	Second Publication:


	Third Publication:

Language Proficency

Include English only if it is not your first language


		Reading

	Reading

Reading


	Use the following scale for rating your fluency 1=low fluency 5=High fluency


	First Language


	Fluency for Language 1


	Speaking


	Second Language


	Writing


	Fluency for Language 2


	Speaking


	Third Language


	Writing


	Fluency for Language 3


	Speaking


	Writing


	What are your major research areas?


	First Research Area

	Second Research Area

	Third Research Area


	What cultures do you have more than a cursory knowledge of?


		First Culture

	Second Culture

	Third Culture


	If you do training (cross-cultural, diversity, etc.), list the three major training areas.


		First Training area

	Second Training area

		Third Training area


	Now, list the three content areas that you would be willing to review manuscripts for the International Journal of Intercultural Relations.


First Review area

		Second Review area

	Third Review area


	Finally, if you are now or have ever taught at a post-secondary institution, please list your three favorite courses that you offered.


		First Course

	Second Course

	Third Course


	That’s all. Please now click on the “Submit” button at the lower right to record your responses.