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APS Site Visit Request Form
This document must be submitted by the chair or their equivalent within national labs or scientific collaborations.
Please use this form to request an APS site visit to assess the climate for women and/or individuals from marginalized groups in your organization. Most site visits happen at least 9 months after the initial request is made. All data collected during the site visit is kept confidential; reports do not contain any identifying information of organizational members. The final report and recommendations are given to the departmental team for their use and consideration.
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Email
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Your email
Name
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Your answer
Phone
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Your answer
Name of institution/department/lab/organization
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Your answer
Title
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Your answer
Have you had a previous site visit?
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Yes
No
If you have had a previous site visit, what year did it take place?
Your answer
If you have had a previous site visit, please provide a brief description of measures taken since the visit.
Your answer
Provide a rough timeline for the requested site visit (Spring, Summer, Fall, Winter). Note: This must be at least 9 months from date of request.
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Your answer
What is the approximate number of tenure track/tenured faculty or permanent scientists for non-academic departments?
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Your answer
What is the approximate number of postdocs/research scientists?
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Your answer
What is the approximate number of non tenure track faculty/teaching faculty/lecturers?
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Your answer
What is the approximate number of graduate students?
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Your answer
What is the approximate number of undergraduate students?
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Your answer
What is the approximate number of staff members?
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Your answer
Please provide a brief rationale of why you would like a site visit. What is your current situation? What is the motivation for this request? What do you hope to achieve from this site visit?
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Your answer
A copy of your responses will be emailed to the address you provided.
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