Foresight Institute Questionnaire: One-minute version
Thanks for taking the time to fill out this one-minute questionnaire, which will help our work and enable us to serve you better. We protect your personal information—for details, please see our Privacy Policy . If you'd like to help Foresight even more, consider filling out the longer questionnaire (approximately five minutes).
Thanks in advance!
Foresight Questionnaire
*All fields in this section are optional
Do you already receive email notices from Foresight?
Please choose one No Not sure Yes
Which of the following uses of nanotechnology interest you? (Check all that
apply)
Other:
How did you hear about Foresight?
Engines of Creation (book)
Unbounding the Future (book)
Nanosystems (book)
Other book:
Web search (enter search engine)
Lecture:
Media coverage:
Colleague referral:
Would you or your company be interested in becoming a corporate sponsor for
conferences or events?
Please choose one
Yes
No
Would you or your company be interested in a co-promotion with Foresight?
Please choose one
Yes
No
Personal Details
*All fields in this section, except state, country and email address, are
optional
Title: Mr. Ms. Mrs. Miss Prof. Dr.
First name:
Last name:
Organization name:
Postal address Line 1:
Line 2:
City:
State/Province:
(Required)
Postal code/Zip code:
Country: USA ALGERIA ARGENTINA AUSTRALIA AUSTRIA BELARUS BELGIUM BERMUDA BOLIVIA BRAZIL CANADA CAYMAN ISLANDS CHILE CHINA COLOMBIA COSTA RICA COTE D'IVOIRE CROATIA CYPRUS CZECH REPUBLIC DENMARK ECUADOR EGYPT ESTONIA FINLAND FRANCE GERMANY GREECE HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN IRELAND ISRAEL ITALY JAPAN KOREA, REPUBLIC OF (SOUTH) KUWAIT LIECHTENSTEIN LITHUANIA LUXEMBOURG MALAYSIA MALTA MAURITIUS MEXICO MONGOLIA NETHERLANDS NETHERLANDS ANTILLES NEW ZEALAND NIGERIA NORWAY other PAKISTAN PERU PHILIPPINES POLAND PORTUGAL ROMANIA RUSSIA SAUDI ARABIA SINGAPORE SLOVENIA SOUTH AFRICA SPAIN SRI LANKA SWEDEN SWITZERLAND TAIWAN THAILAND TURKEY UK UKRAINE UNITED ARAB EMIRATES URUGUAY USA VENEZUELA ZIMBABWE other
(Required)
Continent:
North America
Central/ S America/ Caribbean
Africa
Asia/ Pacific/ Australia
Europe
Email: (Required)
Re-enter email to confirm:
URL:
Tel: Select location Work Home H/W Cell
Fax: Select location Work Home H/W Cell
Thank you for taking the time to fill out this questionnaire—it will
help Foresight maximize the benefits and minimize the drawbacks of
nanotechnology.
Last updated 9 May 2007