Required fields are indicated by an *.
* First Name
* Last Name
* Gender
Male
Female
* DOB / / (MM/DD/YYYY)
* Social Security Number
(XXX-XX-XXXX)
* Major(s)
* Minor(s)
* Cumulative GPA - Based on a 4.0 scale
* Telephone number
* Alternate Telephone
* Email address (where award notification will be sent)
* Home address
* City
* State Select a State Outside United States Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming
* Zip Code
* Current Mailing Address
* City
* State Select a State Outside United States Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming
* Zip Code
* College/University You Are Attending
* City
* State Select a State Outside United States Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming
* Zip code
Travel awards are limited to Southwest Airlines destinations. Please select Departing and Arriving cities below.
* Number of Southwest Airlines roundtrip epass(es) requested. 1 2 3 4
Departure City Choose Departing City Akron/Canton, OH - CAK Albany, NY - ALB Albuquerque, NM - ABQ Amarillo, TX - AMA Atlanta, GA - ATL Austin, TX - AUS Baltimore/Washington, MD - BWI Birmingham, AL - BHM Boise, ID - BOI Boston Logan, MA - BOS Buffalo/Niagara Falls, NY - BUF Burbank, CA - BUR Charleston, SC - CHS Charlotte, NC - CLT Chicago (Midway), IL - MDW Cleveland, OH - CLE Columbus, OH - CMH Corpus Christi, TX - CRP Dallas (Love Field), TX - DAL Dayton, OH - DAY Denver, CO - DEN Des Moines, IA - DSM Detroit, MI - DTW El Paso, TX - ELP Flint, MI - FNT Ft. Lauderdale(Miami area) FL - FLL Ft. Myers/Naples, FL - RSW Grand Rapids, MI - GRR Greenvile/Spartanburg, SC - GSP Harlingen/South Padre Island, TX - HRL Hartford/Springfield, CT - BDL Houston (Hobby), TX - HOU Indianapolis, IN - IND Jacksonville, FL - JAX Kansas City, MO - MCI Las Vegas, NV - LAS Little Rock, AR - LIT Long Island/Islip, NY - ISP Los Angeles (LAX), CA - LAX Louisville, KY - SDF Lubbock, TX - LBB Manchester, NH - MHT Memphis, TN - MEM Midland/Odessa, TX - MAF Milwaukee, WI – MKE Minneapolis/ St. Paul, MN - MSP Nashville, TN - BNA New Orleans, LA - MSY New York (LaGuardia), NY - LGA Newark, NJ - EWR Norfolk/Virginia Beach, VA - ORF Oakland, CA - OAK Oklahoma City, OK - OKC Omaha, NE - OMA Ontario, CA - ONT Orange County/Santa Ana, CA - SNA Orlando, FL - MCO Panama City, FL – ECP Pensacola, FL - PNS Philadelphia, PA - PHL Phoenix, AZ - PHX Pittsburgh, PA - PIT Portland, ME - PWM Portland, OR - PDX Providence, RI - PVD Raleigh-Durham, NC - RDU Reno/Tahoe, NV - RNO Richmond, VA - RIC Rochester, NY - ROC Sacramento, CA - SMF St. Louis, MO - STL Salt Lake City, UT - SLC San Antonio, TX - SAT San Diego, CA - SAN San Francisco, CA - SFO San Jose, CA - SJC Seattle/Tacoma, WA - SEA Spokane, WA - GEG Tampa, FL - TPA Tucson, AZ - TUS Tulsa, OK - TUL Washington (Dulles), DC - IAD Washington (Reagan National) - DCA West Palm Beach, FL - PBI Wichita, KS - ICT
Arrival City Choose Arriving City Akron/Canton, OH - CAK Albany, NY - ALB Albuquerque, NM - ABQ Amarillo, TX - AMA Atlanta, GA - ATL Austin, TX - AUS Baltimore/Washington, MD - BWI Birmingham, AL - BHM Boise, ID - BOI Boston, MA - BOS Buffalo/Niagara Falls, NY - BUF Burbank, CA - BUR Charleston, SC - CHS Charlotte, NC - CLT Chicago (Midway), IL - MDW Cleveland, OH - CLE Columbus, OH - CMH Corpus Christi, TX - CRP Dallas (Love Field), TX - DAL Dayton, OH - DAY Denver, CO - DEN Des Moines, IA - DSM Detroit, MI - DTW El Paso, TX - ELP Flint, MI - FNT Ft. Lauderdale (Miami area) FL - FLL Ft. Myers/Naples, FL - RSW Grand Rapids, MI - GRR Greenvile/Spartanburg, SC - GSP Harlingen/South Padre Island, TX - HRL Hartford/Springfield, CT - BDL Houston (Hobby), TX - HOU Indianapolis, IN - IND Jacksonville, FL - JAX Kansas City, MO - MCI Las Vegas, NV - LAS Little Rock, AR - LIT Long Island/Islip NY - ISP Los Angeles (LAX), CA - LAX Louisville, KY - SDF Lubbock, TX - LBB Manchester, NH - MHT Memphis, TN - MEM Midland/Odessa, TX - MAF Milwaukee, WI - MKE Minneapolis/ St. Paul, MN - MSP Nashville, TN - BNA New Orleans, LA - MSY New York City LaGuardia, NY - LGA Newark, NJ - EWR Norfolk/Virginia Beach, VA - ORF Oakland, CA - OAK Oklahoma City, OK - OKC Omaha, NE - OMA Ontario, CA - ONT Orange County/ Santa Ana, CA - SNA Orlando, FL - MCO Panama City, FL – ECP Pensacola, FL - PNS Philadelphia, PA - PHL Phoenix, AZ - PHX Pittsburgh, PA - PIT Portland, ME - PWM Portland, OR - PDX Providence, RI - PVD Raleigh-Durham, NC - RDU Reno/Tahoe, NV - RNO Richmond, VA - RIC Rochester, NY - ROC Sacramento, CA - SMF St. Louis, MO - STL Salt Lake City, UT - SLC San Antonio, TX - SAT San Diego, CA - SAN San Franciso, CA - SFO San Jose, CA - SJC Seattle/Tacoma, WA - SEA Spokane, WA - GEG Tampa, FL - TPA Tucson, AZ - TUS Tulsa, OK - TUL Washington (Dulles), DC - IAD Washington (Reagan National) - DCA West Palm Beach, FL - PBI Wichita, KS - ICT
* Student Classification Select One Freshman Sophomore Junior Senior Graduate Student Professional School
Release
My information can be used for other HACU programs
I only want to be considered for this award
* Father's Name
* Country of ancestral origin
* Mother's Name
* Country of ancestral origin
* Do you speak Spanish?
Yes
No
* Conversationally?
Yes
No
* Fluently?
Yes
No
INSTRUCTIONS FOR ESSAY QUESTIONS Please answer the following questions that apply to you as the student. Each question must be answered in 300-500 words. Essays will be evaluated for content and grammar. Failure to complete the questions below will render your application ineligible. (Note: applications with less than 300 words will NOT be reviewed.) For Scholarship essay writing tips, visit www.academictips.org
Required for all students. Please answer the following question:
* What are your challenges getting a college degree? (Please be specific and explain your unique circumstances.)
COLLEGE UNDERGRADUATE STUDENTS Are you either a high school graduating senior or undergraduate college student?
* If YES, answer the following question. If NO, skip to next section.
Yes
No
If selected, how would travel on Southwest Airlines benefit you and your family? (Please be specific and explain your unique circumstances in 300-500 words.)
GRADUATE STUDENTS Are you a college graduate student working on a Masters or Ph.D?
* If YES, answer the following questions. If NO, skip to next section.
Yes
No
How would the airline epass(es) be used to help meet your goals as a graduate student? (Please be specific and explain your unique circumstances in 300-500 words.)
Please list all current AND expected financial support related to your graduate academics.*
*(i.e., graduate assistantships, fellowships, departmental stipends, travel support from graduate student associations, etc.)
PREVIOUS TRAVEL AWARD RECIPIENT Are you a previous Southwest Airlines Program Lánzate recipient?
* If YES, answer the following question. If NO, skip to next section.
Yes
No
Please explain how you used the tickets. How did it help you and your family? (200 word minimum essay - Please be specific and explain your unique circumstances.)
STUDENT CERTIFICATION
I hereby agree that Southwest Airlines and HACU shall have, without further obligation to me, the right to use my name, voice, likeness, essays, and/or photograph and biographical information for advertising and promotional purposes in conjunction with this and similar promotions without notice to me and without further compensation unless prohibited by law.
If selected, I understand that I will be required to submit an Enrollment Verification Form from the college or university I am attending and a completed W-9 Form (collectively, the "Required Documentation") by August 15, 2016, or the travel award will be forfeited and an alternate student recipient may be chosen.
It is understood and agreed that this is a complete RELEASE and DISCHARGE of all claims and rights of the undersigned against the aforementioned parties to be released, and that no action will be taken by or on behalf of the undersigned with respect to any such rights, it being understood that this release shall be binding upon the heirs, executors, and administrators of the undersigned.
I agree to hold sponsor, Southwest Airlines, and each of their parent, subsidiary and affiliated corporations, and the officers, shareholders, directors, employees, agents and representatives harmless against any and all claims or liability arising directly or indirectly from use or misuse of a travel award or participation in the Award Program.
I also give my authorization, permission and consent to HACU to contact and receive information from any institution, agency, college/university and/or persons for the following purposes:
a. to verify any of the information I have provided
or may provide to HACU, and/or
b. to obtain any other information concerning my scholastic/academic status in order to assess and monitor my qualifications and/or continued eligibility for this or any other award.
The authorizations, permissions and consents I have hereby given shall remain in full force and effect unless I revoke this consent in writing by letter addressed to HACU’s Development Department in San Antonio, Texas.
I hereby verify that all of the information I have provided is complete and accurate to the best of my knowledge. I further acknowledge and agree that any incomplete or false information may result in my application not being considered or in the termination of any award which may be granted.
Final Submission Notice
Please note that once you agree to these terms and submit the application you will not be able to edit, change or update this application. Therefore, please take a moment to double check all of your personal information and make sure that there are no grammatical mistakes in the essay.
* Click here to agree to above Terms and Conditions.
How did you hear about the Lanzate Premio Universitario de Southwest Airlines?
(Take Off! Higher Education Award from Southwest Airlines)