Bridges

This form is for schools/organizations to reserve space for your students at Portland State University's annual Bridges event. You will receive follow-up communications with additional information once you submit the form.

First Name

Last Name

Job Title

Phone Number

Email Address

School/Organization Name
(Start typing, then select your school from the options that appear below the text box)

School/Organization Mailing Address
Enter the mailing address for the organization or school submitting this form. Please do not enter any personal information.

Country

Street

City

Region

Postal Code

Is there a different day-of contact for this group?

Yes

No

Your Day-Of Phone Number

Enter the Contact Information for the Day-Of Coordinator

First Name

Last Name

Email Address

Day-Of Phone Number

Number of Chaperones Attending
Select the number of chaperones attending, not including yourself.

Chaperone Contact Information

Chaperone 1

Chaperone 1: First and Last Name

Chaperone 1: Email Address

Chaperone 2

Chaperone 2: First and Last Name

Chaperone 2: Email Address

Chaperone 3

Chaperone 3: First and Last Name

Chaperone 3: Email Address

Chaperone 4

Chaperone 4: First and Last Name

Chaperone 4: Email Address

Chaperone 5

Chaperone 5: First and Last Name

Chaperone 5: Email Address

Transportation

How will you travel to campus?
Select all that apply.

Car/SUV/Minivan/Large Van(s)

Public Transportation

We do not provide bus parking, please make arrangements for bus drop off and pick up only.

Student Participant Details

Number of Students
Maximum is 40 students.

Grades Attending
Select all that apply. Due to capacity, 9th and 10th graders are not accepted at this time.

11th

12th

Will any of your students participate in the application workshop?
The $60 application fee is waived for eligible domestic students who apply to PSU at Bridges.

Yes

No

Other language(s) spoken by your students at home besides English:

Anything else you would like for us to know about your group?