National Roster of Professional Women Questionnaire, 1971

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[handwritten] File 
 
 NATIONAL ROSTER OF PROFESSIONAL WOMEN
 
 Social Security Number 
 
 1 . Name
 Last - First - Middle or Maiden
 
 2. Address
 Number - Street
 City - State - ZIP
 
 3. In what year were you born?‘
 Year
 
 4. Are you: (Circle One)
 White/Caucasian 1
 Black/Negro/AfroAmerican 2
 Oriental 3
 American Indian 4
 Mexican American 5
 Puerto Rican American 6
 Other 7
 
 5. Where were you born? (Circle One)
 USA 1
 Canada 2
 Central or South America 3
 Western Europe 4
 Eastern Europe 5
 Africa 6
 Far East 7
 Middle East 8
 
 6. Your religion (Circle one in each column)
 Religion - Religion in which you were reared - Present religious preference 
 Protestant 1
 Roman Catholic 2 
 Jewish 3
 Quaker 4
 None 5
 Other (specify) 6
-2-
 
 7. Your political orientation. (Circle One) 
 Very conservative 1
 Conservative 2
 Moderate (middle of the
 road) 3
 Liberal 4
 Left 5
 Far left 6
 Other (specify) 7
 
 8. Marital Status (Circle One)
 Single 1
 Religious order 2
 Married 3
 Separated 4
 Divorced 5
 Widowed 6
 
 9. Children
 None 1 
 One 2
 Two 3
 Three 4
 Four or more 5
 
 10. Highest level of education completed by your present husband.
 If not currently married skip to Question 13. (Circle One)
 Less than high school 1
 High school graduate 2
 Some college 3
 College graduate 4
 Some graduate work 5
 Graduate degree or
 professional degree 6
 
 11. Husband's field or occupation (Circle One)
 Physical scientist 1
 Agricultural or biological
 scientist 2
 Physician or lawyer 3
 Social scientist 4
 Artist 5
 Businessman 6
 Lawyer 7
 Teacher (Elementary/Secondary) 8
 College Teacher 9
 Other (state or govt official,
 unskilled, semiskilled, skilled,
 clergy, etc) 10
 
-3-
 
 12. Husband's gross yearly income
 Less than $5,000
 $5,000—9,999 1
 $l0,000—l4,999 2
 $l5,000—l9,999 3
 $20,000~29,999 4
 $30,000—39,999 5
 $40,000 or more 6
 
 13. Check all degrees received. - Year
 AA
 Bachelor's
 Master's
 Ph.D.
 Ed.D.
 M.D. or D.D.S.
 LL.B., J.D.
 Other doctorate
 Other
 
 14. Institution of highest degree
 Name - State
 
 15. Field of specialization of your highest degree. *See listing and
 write in code (SPECIALITIES LIST)
 Code Number
 
 16. What do you consider your present discipline. *See listing and
 write in code (SPECIALITIES LIST)
 Code Number
 
 17. Present employment.
 A. Title or position (Circle one)
 Post doctoral fellow 1
 Lecturer, teacher, instructor 2
 Assistant Professor 3
 Associate Professor 4
 Full Professor 5
 Academic Administrator 5
 Research Associate 7
 Research Director 8
 Consultant 9
 Counselor 10
 Other 11
-4-
 
 B. Employer:
 Industry or Business 1
 Government (state or local) 2
 Nonprofit organization 3
 Academic: Elem./Secondary Education 4
 Two-Year College 5
 Four-Year College 6
 University 7
 Private practice 8
 Clinic or hospital 9
 Other
 
 C. Years with present employer
 Less than 1
 One
 Two
 Three
 Four
 Five
 Six
 Seven
 Eight
 Nine or More
 
 D. Are you working full time
 
 Full time 1
 Part-time, more than half 2
 Part-time, about half 3
 Part-time, less than half 4
 
 E. Annual professional income
 Less than $5,000 1
 $5,000-9,999 2
 $10,000-14,999 3
 $15,000-19,999 4
 $20,000-29,999 5
 $30,000-39,999 6
 $40,000 or more 7
 
 If academic: is your salary based on
 9-10 month basis 1
 11-12 month basis 2
5
 
 F. Approximately what is the percentage of time you spend in each
 of the activities at your present job.
 Activity- Percentage
 Teaching
 Administration
 Research
 Services to clients
 Other
 
 18. How many years have you worked in jobs relevant to your field of
 specialization?
 Less than one 1
 1-3 years 2
 4-6 years 3
 7-9 years 4
 10-12 years 5
 13-15 years 6
 16 or more years 7
 
 19. How many different jobs have you had since your highest degree;
 Count only different employers not changes in title within same
 employment setting.
 One 1
 Two 2
 Three 3
 Four 4
 Five 5
 Six 6
 Seven 7
 Eight 8
 Nine or more
 
 20. Indicate the three activities in which you have the greatest 
 competence and write in the number of years spent on each one of the
 three activities you check. 
 Activity - Number of Years
 
 Management or administration of
 research and development
 
 Management or administration
 of other than research and
 development
 Clinical research/investigation
 Basic research
 Applied research
 Teaching
 Report or other technical
 writing, editing
 Development
6
 
 Question 20 continued
 Design
 Clinical practice
 Psychological test development
 Equipment or systems research
 Industrial or management
 consulting
 Administration, Interpretation
 or psychological tests
 Other (specify)
 
 21. Publications
 Number of articles published within field of specialization
 Number of papers presented in professional meetings other than
 above
 Number of books published
 Publications other than ones related to your field of
 specialization
 
 22. Special honors. (Check all that apply)
 Received an award for performance as a teacher
 Received an award for performance as a community leader
 Received an award for my research
 Listed in Who's Who in America
 Listed in Men of Science
 
 23, Have you had any job offers during the last year? Yes 1
 No 2
 If YES: List number of offers.
 
 24. Are you currently negotiating for a new job? 
 Yes 1
 No 2
 
 25. would you be interested in a change of job? 
 Yes 1
 No 2
 
 26. IF YES
 Would you consider a job in a new location? 
 Yes 1
 No 2
MATHEMATICS 
 000 - Algebra 
 010 - Analysis & Functional Analysis 
 020 - Geometry
 030 - Logic
 040 - Number Theory
 050 - Probability 
 (see also 544, 670, 725, 727, 920)
 060 - Topology
 080 - Computing Theory & Practice 
 085 - Applied Mathematics 
 087 - Mathematics of Resource Use 
 098 - Mathematics, General 
 099 - Mathematics, Other*
 
 ASTRONOMY 
 101 - Astronomy 
 102 - Astrophysics     
 
 PHYSICS 
 (Note: Theoretical scientists mark "T" on questionnaire following code no.)
 110 - Atomic & Molecular Physics
 120 - Electromagnetism
 130 - Mechanics 
 132 - Acoustic
 135 - Plasma Physics
 136 - Optics
 138 - Thermal Physics
 140 - Elementary Particles 
 150 - Nuclear Structure
 160 - Solid State
 198 - Physics, General 
 199 - Physics, Other*
 
 CHEMISTRY
 200 - Analytical 
 210 - Inorganic 
 220 - Organic
 230 - Nuclear
 240 - Physical 
 250 - Theoretical 
 260 - Agricultural & Food
 270 - Pharmaceutical 
 298 - Chemistry, General 
 299 - Chemistry, Other*
 
 BIOCHEMISTRY
 540 - Biochemistry
 
 EARTH SCIENCES 
 301 - Mineralogy, Petrology
 305 - Geochemistry 
 310 - Stratigraphy, Sedimentation
 320 - Paleontology
 330 - Structural Geology
 340 - Geophysics (Solid Earth &
 Atmospheric)
 350 - Geomorph, Glacial Geology
 360 - Hydrology
 370 - Oceanography 
 380 - Meteorology
 391 - Applied Geol., Geol. Engr.,
 Econ. Geol.
 395 - Fuel Technology, Petrol. Engr. 
 398 - Earth Sciences, General 
 399 - Earth Sciences, Other*
 
 ENGINEERING
 400 - Aeronautical & Astronautical
 410 - Agricultural
 415 - Biomedical Engineering
 420 - Civil
 430 - Chemical
 435 - Ceramic
 440 - Electrical 
 445 - Electronics
 450 - Industrial 
 460 - Engineering Physics
 470 - Mechanical 
 475 - Metallurgy & Phys. Met. Engr. 
 430 - Sanitary
 486 - Mining
 498 - Engineering, General
 499 - Engineering, Other*
 
 AGRICULTURAL SCIENCES
 500 - Agronomy
 502 - Animal Husbandry
 504 - Fish & Wildlife
 505 - Forestry
 506 - Horticulture 
 507 - Range Management 
 508 - Agriculture, General 
 509 - Agriculture, Other*
 
 MEDICAL SCIENCES
 510 - Medicine & Surgery
 511 - Pharmacy 
 512 - Public Health
 513 - Veterinary Medicine 
 514 - Hospital Administration 
 518 - Medical Sciences, General 
 519 - Medical Sciences, Other*
 
 BIOLOGICAL SCIENCES
 520 - Anatomy
 522 - Cytology
 524 - Embryology
 530 - Physiology, Animal 
 532 - Physiology, Plant
 534 - Pathology 
 536 - Pharmacology  
 542 - Biophysics 
 544 - Biometrics, Biostatistics
 (see also 050, 670, 725, 727, 920)
 550 - Botany
 552 - Phytopatholgy
 560 - Ecology
 562 - Hydrobiology
 564 - Microbiology & Bacteriology 
 570 - Genetics 
 580 - Zoology
 582 - Entomology
 584 - Molecular Biology
 598 - Biological Sciences, General
 599 - Biological Sciences, Other*
 
 PSYCHOLOGY
 600 - Clinical
 610 - Counseling & Guidance 
 620 - Developmental & Gerontological
 630 - Educational 
 635 - School Psychology
 641 - Experimental 
 642 - Comparative
 643 - Physiological
 650 - Industrial & Personnel
 660 - Personality
 670 - Psychometrics 
 (see also 050, 544, 725, 727, 920)
 680 - Social
 698 - Psychology, General
 699 - Psychology, Other*
 
 SOCIAL SCIENCES
 700 - Anthropology
 710 - Sociology
 720 - Economics
 725 - Econometrics
 (see also 050, 544, 670. 727, 920) -
 727 - Statistics
 740 - Geography 
 745 - Area Studies 
 750 - Political Science, Public Administration
 755 - International Relations 
 760 - Social Work 
 770 - Urban & Reg. Planning 
 798 - Social Sciences, General 
 799 - Social Sciences, Other*
 
 ARTS & HUMANITIES 
 801 - Art, Applied 
 802 - Art, History & Criticism
 815 - Speech as a Dramatic Art
 (see also 885)
 830 - Music
 705 - Archeology
 731 - History, American 
 732 - History, European 
 733 - History, Other* 
 734 - History & Philos. of Science 
 
 LANGUAGES & LITERATURE 
 811 - American
 812 - English
 821 - German
 823 - French
 824 - Spanish & Portuguese
 826 - Italian 
 827 - Russian
 822 - Classical*
 829 - Other Languages*
 825 - Linguistics
 840 - Philosophy
 888 - Arts & Humanities, General 
 889 - Arts & Humanities, Other*
 
 EDUCATION 
 900 - Foundations: Social, Philosoph. 
 910 - Educational Psychology
 920 - Educ. Meas. & Stat. 
 930 - Educ. Admin. & Superv. 
 940 - Guid., Couns., & Student Pers. 
 950 - Special Education (Speech, Gifted, Handicapped, etc.) 
 960 - Audio-Visual Media 
 
 TEACHING FIELDS
 970 - Agriculture 
 972  - Art
 974 - Business
 976 - English
 978 - Foreign Language
 980 - Home Economics
 982 - Industrial Arts
 984 - Mathematics
 986 - Music
 988 - Phys. Ed., Health,
 & Recreation
 990 - Science Educ.
 992 - Social Science Educ.
 994 - Vocational Educ.
 996 - Other Fields 
 908 - Elementary Educ., General 
 909 - Secondary Educ., General
 998 - Education, General
 999 - Education, Other*
 
 OTHER PROFESSIONAL FIELDS 
 850 - Business Administration 
 855 - Home Economics 
 860 - Journalism 
 865 - Law, Jurisprudence
 870 - Library & Archival Science
 880 - Religion & Theology 
 885 - Speech & Hearing Sciences
 897 - Professional Field, Other*
 
 899 - OTHER FIELDS*
 
 *Identify the specific field in the space provided on the questionnaire.