|NATIONAL SCIENCE FOUNDATION (NSF) PRESIDENTIAL AWARDS FOR EXCELLENCE IN SCIENCE, MATHEMATICS AND ENGINEERING MENTORING PROGRAM INFORMATION FORM|
|The following information will be used for the clearance required for Presidential Awards should your nomination for a Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring (PAESMEM) be recommended by the National Science Foundation (NSF) to the White House. Each nominee should read and sign this form under the Disclosure Statement.|
NOMINEE DISCLOSURE STATEMENT
I, the undersigned Presidential Mentoring nominee, by signing this form acknowledge that I have been informed that the information contained on this form and the nomination submission will be available to those individuals directly involved in the review and award process at the National Science Foundation (NSF) and the White House. I authorize the disclosure of nominating materials to those individuals implementing the review and award process.
If permanent resident status is checked, I also authorize disclosure of identifying information from my nomination materials to the U.S. Immigration and Naturalization Service for the purpose of verifying permanent resident status.