This manual provides tools and information to develop successful bridge programs, based upon the development and implementation of Carreras en Salud (English translation is Careers in Health), an early bridge prototype that has achieved significant outcomes and national recognition. The manual is useful to administrators of adult and vocational programs, instructors, employers, and others involved in assisting low-skill adults, whether the skills they need are ESL or ABE. The program is a partnership of the Instituto del Progresso Latino, Humboldt Park Vocational Education Center of Wilbur Wright College, National Council of La Raza, and Association House of Chicago.