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  ![](media/image1.emf){width="0.90625in"   **ANNUAL SUPPLEMENT\
  height="0.5625in"}                        TO THE PROFESSIONAL RESUME**

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  For the period                         to                      
  from                                                           

  (To be decided by                                              
  the Division                                                   
  Head)                                                          
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  ---------------- -- ------ ------- ----------- -------- ------- ---------- ----- --------------------- --
  Name                                                            Division                               

                      Last           First       Middle                                                  

  LBNL                                                    Title                                          
  Classification                                          Code                                           
  ---------------- -- ------ ------- ----------- -------- ------- ---------- ----- --------------------- --

*(100-150 Classification Series - IXX.3, .4, .5, .6, .7, .9, and 0.
only)*

**NOTE: INFORMATION CONTAINED HEREIN IS OPEN TO ACCESS TO THE PUBLIC.**
*Copies of this Supplement will be maintained in the offices of the
Director and Division Head and are considered by the Laboratory to be
non-confidential in nature and therefore subject to public inspection
under the California Public Records Act.*

I. LBNL RESPONSIBILITIES AND ACHIEVEMENTS

*Succinct statement of professional, management and administrative roles
(e.g., principal investigator, project manager, facility manager,
department officer, spokesman of experiment) on specific projects and
programs with particular attention to significant advances, creative
accomplishments, program expansions and planning for new endeavors.
These activities may include original research, design, development, or
productive utilization of the Laboratory facilities.*

II\. PUBLICATIONS, RESEARCH, AND OTHER CREATIVE ACTIVITY

*List all research and creative accomplishments. Cite only items not
submitted on previous professional resume. Give a full bibliographical
citation for each item, or an equivalent reference if the work being
cited is not represented in the form of publication. If all or part of
your recent work does not lend itself to publications, please write a
short narrative of this work and your interests during this time. List
items in the following order:*

1\. Refereed journals

2\. Non-refereed journals, books, proceedings

3\. Abstracts

4\. Publications for which you were supervisor but not co-author
(indicate your role)

5\. LBNL reports

6\. Other reports (e.g., internal notes, technical reports to government
agencies, committee reports)

7\. Patents

8\. Other

III\. RESEARCH SUPERVISION

*Direct supervision of scholars (give names, dates, and research
topics)*

1\. Graduate Students

2\. Post Doctoral and Visiting Scientist

IV\. LBNL / UNIVERSITY COMMITTEE SERVICE

1\. Lab-Wide

2\. Divisional

3\. University

V. PROFESSIONAL ACTIVITIES

> 1\. Invited lectures, papers at meetings and similar activities
>
> 2\. Service as an editor or reviewer for scholarly journals or other
> publications
>
> 3\. Service to scholarly or professional societies (e.g., officer,
> committee member, or other provision of professional services)
>
> 4\. Service to the University of California (e.g., Course Instruction)
>
> 5\. Service to educational or governmental agencies (includes serving
> on committees, panels or commissions established by governmental
> agencies from the local to international level)
>
> 6\. Consulting service in providing professional, managerial, or
> technical assistance to clients, private corporations, non-profit
> organizations, or various levels of governmental agencies (including
> foreign governments)

VI\. AWARDS AND HONORS

> 1\. Prizes, fellowship, honors, commendations, special lectureships
>
> 2\. Membership in Honorary Societies
>
> 3\. Fellow Grade Membership in Scientific Societies

VII\. EDUCATION

*Professional courses (including continuing education) taken and degrees
or certificates earned*

**VIII. FUNDED PROPOSALS**

**IX. OTHER**

*Optional information such as community service*

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  I have filled out the above items or have reviewed them for accuracy.
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