APS Bridge Program
 
Institutional Information:
* Institution:
Website:
* Department:
Address1:
Address2:
Address3:
City:  State:  Zip: 
  *  What type of institution are you? (Select one, according to the highest degree in physics offered at your institution):
  Bachelor 's     Master 's     Doctoral     Affiliate *

Contact Faculty:
  Please list any faculty at your institution interested in increasing educational opportunities for underrepresented minority physics students. These contacts will receive news and project updates via the Bridge Program email list.
               Main Faculty Contact
* Name:
* Email:
Phone:
Address1: 
Address2: 
Address3: 
City:  State:  Zip: 
               Additional Contact 1
Name:
Email:
Phone:
Address1: 
Address2: 
Address3: 
City:  State:  Zip: 
               Additional Contact 2
Name:
Email:
Phone:
Address1: 
Address2: 
Address3: 
City:  State:  Zip: 
               Additional Contact 3
Name:
Email:
Phone:
Address1: 
Address2: 
Address3: 
City:  State:  Zip: 

* Diversity Initiatives:
  Does your university or department have any current or planned diversity initiatives or programs that would be helpful to underrepresented minorities in your department?
  
   0 Characters Entered. (1000 characters remaining.)

Minority Physics Degrees Awarded:
  How many underrepresented minority physics students have graduated from your institution during the past three years? For this program, APS defines the term underrepresented minority as African Americans, Hispanic Americans, or Native Americans who are U.S. citizens or permanent residents. We ask that you update these numbers annually to maintain your membership.
  Bachelor's degrees
(3 year total)
Master's degrees
(3 year total)
Doctorate degrees
(3 year total)
African American         
Hispanic American        
Native American        
Total          
* Currently Enrolled:
  Please comment on enrollment of underrepresented minority physics students at your institution.
  
   0 Characters Entered. (1000 characters remaining.)

Comments (optional):
  Please provide any additional comments or information about your institution's minority graduation and enrollment rates.
  
   0 Characters Entered. (1000 characters remaining.)


Faculty Members:
  How many underrepresented minority faculty members are in the department? Postdoctoral researchers?
Number of minority tenure-track or tenured faculty in the department:  
Total number of tenure-track or tenured faculty in the department:  
Number of minority postdocs in the department:  
Total number of postdocs in the department:  

How did you hear about the APS Bridge Program? (check all that apply)
     At a conference:    
     From a colleague
     From a member of the project staff
     From a print publication:    
     From a website:    
     Other: