Mars Exploration: Zip Code Mars - Individual Contribution


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Zip Code Mars: Individual Contribution Submission

Your Background Information (Step Selected) Your Mars Mission Contribution Your Personal Reflections Review and Submit

Thank you for taking the time to help us share the adventure.

This form is divided up into three sections for you to fill out sequentially: Your Background Information, Your Mars Mission Contributions, and Your Personal Reflections.

Please Note: Depending on your internet connection uploading images may take some time. Please do not close your browser until you have filled out all three sections of this form.

The required fields are noted by a red asterisk *

Your Background Information

By filling out this section you will help us create the following format for your profile.

First Name *

Last Name *

Affiliation *

Title *

City *

State or Province *

State:

Province:

Country *

Contact Information

The contact phone number and email address will not be made public. It is for verification purposes ONLY!

Contact
Phone Number *

EXT.

Contact
Email Address *

Education Information

High School

Name
City
State

College/University

Name of Degree (Undergraduate)
Name of Institution (Undergraduate)
Name of Degree (Graduate)
Name of Institution (Graduate)
Name of Degree (Doctorate)
Name of Institution (Doctorate)

Please attach a picture of yourself for the main profile image.
** Image Requirements **

Size: Largest Available
Resolution: 300 DPI Preferred
Format: JPG, GIF OR TIF ONLY

(Please make sure the file name is not longer than 28 characters, it does not contain special characters such as / \ : * ? " < > | and it ends with one of the following extensions .jpg, .gif, .tif, or .tiff)

Profile Image
Hi Resolution *

What is your background (bio)? *