HBCU/BSI Department Review Interest Form

HBCU/BSI Department Review Interest Form

The Effective Practices for Physics Program (EP3) Initiative is undertaking site visits at HBCUs/BSIs to help departments develop plans that will increase their number of graduating majors. These site visits can also serve as an external site visit for departments.
Please fill out this survey if you are interested in taking part in a site visit through the EP3 Initiative. The external reviews will be conducted by a team of 3 visitors. We have found that in-person visits are important for the success of these efforts.
Name of Applicant*

First Name Last Name
Email*
example@example.com
Institution name*
Name of Department Chair

Department Staffing

	1-5	6-10	11-15	>15
What is the total number of instructional staff FTEs in your department?
How many of these would be able to participate in a group working on this issue?

Please indicate your level of interest in having an external program review team visit your school in the next two years.

HighMediumLowInterested, but not in the next 2 yearsNot interested
Please list any particular reasons that you would like the committee to consider you for one of our external program reviews.
Briefly describe any existing plans for increasing the number of majors in your department.
Would you be willing to serve as an external reviewer for another department?

YesNoMaybe
Do you have particular timing constraints for when a visit could take place?
Should be Empty: