2021-22 Academia de Liderazgo Application/Nom Form - Hispanic Association of Colleges and Universities

HACU'S LA ACADEMIA DE LIDERAZGO
(THE LEADERSHIP ACADEMY)

APPLICATION FOR ADMISSION / NOMINATION FORM

2022-2023

Please review the application form and assemble all required information and attachments, including letters of recommendation. Regrettably, our current state of technology will not allow you to return to an incomplete form. ALL REQUIRED FIELDS OF THE APPLICATION MUST BE COMPLETED AT ONE SITTING. HACU apologizes for the inconvenience.

Please answer all application questions and submit all required materials for review by the Selection Committee.

You may complete this application for yourself or nominate someone else. Applications need to be submitted online.

Completed applications are due no later than midnight March 25, 2022, for consideration in the 2022-2023 class of Leadership Fellows.

I certify that all the information and accompanying materials provided in connection with this application are authentic and accurate.

*Required fields are indicated by an .**
* NAME OF PERSON COMPLETING APPLICATION:
I. GENERAL INFORMATION
* First Name of Applicant or Nominee:
* Last Name of Applicant or Nominee:
* Title or position
* Institution
* Address
* City:
* State:
* Zip:
* Country
* Telephone:
* E-mail Address:
* GENDER: I identify my gender as:
* ETHNIC ORIGIN (select one):
* INSTITUTION TYPE (select one)	DEFINITIONS Hispanic-Serving Institution (HSI) – a nonprofit, accredited college, university, or system/district in the U.S. or Puerto Rico, where total Hispanic enrollment constitutes a minimum of 25% of the total enrollment at the undergraduate or graduate level. Emerging HSI – a nonprofit, accredited college, university, or system/district in the U.S. or Puerto Rico, where total Hispanic enrollment constitutes at least 10% of the total enrollment, or where a minimum of 1,000 Hispanic students are enrolled at the undergraduate or graduate level
II. EDUCATION
* Highest degree obtained
* University conferring degree
* Field of study
* Graduation Year
III. WORK EXPERIENCE List your or the nominee’s positions in reverse chronological order, starting with the current or most recent one. If all positions are in the same higher education institution, please give the major promotional sequence.
* 1. NAME OF INSTITUTION
* TITLE OR POSITION
* FROM	/ / (MM/DD/YYYY)
* TO	/ / (MM/DD/YYYY)
* 2. NAME OF INSTITUTION
* TITLE OR POSITION
* FROM	/ / (MM/DD/YYYY)
* TO	/ / (MM/DD/YYYY)
* 3. NAME OF INSTITUTION
* TITLE OR POSITION
* FROM	/ / (MM/DD/YYYY)
* TO	/ / (MM/DD/YYYY)
* 4. NAME OF INSTITUTION
* TITLE OR POSITION
* FROM	/ / (MM/DD/YYYY)
* TO	/ / (MM/DD/YYYY)
5. PLEASE ESTIMATE TOTAL YEARS OF PROFESSIONAL EXPERIENCE:
* Number of Years:
6. PLEASE UPLOAD A COPY OF YOUR (OR THE NOMINEE'S) CURRICULUM VITAE.
* Upload CV Here: (Please make sure the name of the uploaded file does not contain any characters like periods, hyphens or slashes.)
7. Describe your (or the Nominee’s) current responsibilities, including level in the organization.
* *(500 word limit)*
8. Explain the objectives and goals as they relate to you (or the Nominee) attending this program. Also describe what you think other program participants may learn from your (or the Nominee’s) participation in this academy (e.g., perspectives, skills, expertise).
* *(500 word limit)*
9. What do you anticipate are the next steps in your (or the Nominee’s) career progression to a presidential position?
* *(500 word limit)*
10. How would you characterize your (or the Nominee’s) leadership strengths and weaknesses? Provide examples as appropriate.
* *(500 word limit)*
11. What are the most formidable challenges facing college presidents today?
* *(500 word limit)*
IV. LETTERS OF REFERENCE INFORMATION HACU’s La Academia de Liderazgo requires that two letters of reference be completed by a senior executive or board member within the institution, or a colleague or former supervisor familiar with the candidate’s character, role, and responsibilities, who can provide a detailed firsthand account of the applicant’s leadership potential, skills and abilities. FIRST REFERENCE:
* Referring Institution Name:
* Name of Reference:
* Title or Position:
* Email:
* Referring Institution Name:
* Name of Reference:
* Title or Position:
* Email:
* Upload Reference Letter 1 (Please make sure the name of the uploaded file does not contain any characters like periods, hyphens or slashes.)
* Upload Reference Letter 2 (Please make sure the name of the uploaded file does not contain any characters like periods, hyphens or slashes.)
V. BILLING INFORMATION Tuition is $10,000 for HACU-Member institutions and $15,000 for non-members per selected participant. Tuition covers all program materials, HACU conference registrations and selected meals. An invoice will be emailed to the individual indicated below.
* NAME:
* TITLE OR POSITION:
* INSTITUTION NAME:
* INSTITUTION ADDRESS:
* CITY:
* STATE:
* ZIP CODE:
* INSTITUTION TELEPHONE:
* FAX:
* EMAIL:
VI. CANCELLATION POLICY Payment is due within 30 days of the invoice date. Cancellations or deferrals must be submitted in writing more than 30 days before the program start date to receive a full refund. Due to program demand and the volume of preprogram preparation, cancellations or deferrals received 14 to 30 days before the program start date are subject to a fee of one-half of the program fee. Requests received within 14 days of the program start date are subject to full payment of the program fee. Upon acceptance, payment is required prior to the program start date.
* I have read the cancellation policy and agree to the terms stated. (initial here):

The Hispanic Association of Colleges and Universities, founded in 1986, represents more than 500 colleges and universities in the United States, Latin America, Spain, and school districts throughout the U.S. HACU is the only national association representing existing and emerging Hispanic-Serving Institutions (HSIs). The Association’s headquarters are in San Antonio, Texas, with regional offices in Washington, D.C. and Sacramento, California.

HACU'S LA ACADEMIA DE LIDERAZGO
(THE LEADERSHIP ACADEMY)

APPLICATION FOR ADMISSION / NOMINATION FORM

2022-2023

Completed applications are due no later than midnight March 25, 2022, for consideration in the 2022-2023 class of Leadership Fellows.

I certify that all the information and accompanying materials provided in connection with this application are authentic and accurate.

Subscribe to HACU Newsletter and Updates

Social Media

National Headquarters

Washington, D.C. Office

Western Regional Office

HACU'S LA ACADEMIA DE LIDERAZGO (THE LEADERSHIP ACADEMY) APPLICATION FOR ADMISSION / NOMINATION FORM

2022-2023

Completed applications are due no later than midnight March 25, 2022, for consideration in the 2022-2023 class of Leadership Fellows. I certify that all the information and accompanying materials provided in connection with this application are authentic and accurate.

Subscribe to HACU Newsletter and Updates

HACU'S LA ACADEMIA DE LIDERAZGO
(THE LEADERSHIP ACADEMY)

APPLICATION FOR ADMISSION / NOMINATION FORM

Completed applications are due no later than midnight March 25, 2022, for consideration in the 2022-2023 class of Leadership Fellows.

I certify that all the information and accompanying materials provided in connection with this application are authentic and accurate.