Contact Information (For Person Filling out This Form)

This form is the first step in requesting funding from the Bridge Fund for Faculty of Color Hires. The Office for Equity and Diversity will use information from this form to determine if submission of a full proposal is merited. Additional information may be requested at any time by our office. Note that submission of this preliminary request and/or a full proposal does not indicate funding is approved. The Office for Equity and Diversity will contact you if a full proposal is warranted.
Email completed form to Sean Garrick, Associate Vice Provost for Equity and Diversity at:
Contact Information (For person filling out this form)
Name
Title
Department and College
Address
Phone
Email
Fax
Preliminary Information
What is the proposed classification of the appointment?
What is the proposed start date of appointment?
Will this be a new or replacement hire for your department?
Currently, where in the search process is your department?
Briefly state how this position advances your department’s diversity goals.
Has your college’s dean formally approved this funding request?
Faculty Candidate Information (complete only if candidate has already been chosen)
What is the name of the faculty candidate?
What is their area of academic expertise?
Where did they receive their degree?
What is their demographic background?
Financial support information
What is the amount of the proposed salary?
Fiscal year funding to begin?
List proposed percentage of base salary requested for each year. / Yr. 1 / Yr. 2 / Yr. 3
What is the total amount of salary and fringe for each year? / Yr.
1 / Yr. 2 / Yr. 3
What is the combined total amount of salary and fringe?