Required fields are indicated by an *. Applications must be completed by April 29, 2011. Award recipients will be
notified the week of July 4, 2011. * First Name * Last Name * Major(s) * Minor(s) * Cumulative GPA - Based on a 4.0 scale * Expected Graduation Date (MM/DD/YYYY) * Telephone number * Alternate Telephone * Email address * Permanent 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 * 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 Travel awards are limited to Southwest Airlines destinations. Please select Departing and Arriving cities below. * Number of Southwest Airlines roundtrip tickets requested. 1 2 3 4 Departure City Choose Departing City Albany, NY - ALB Albuquerque, NM - ABQ Amarillo, TX - AMA Austin, TX - AUS Baltimore/Washington, MD - BWI Birmingham, AL - BHM Boise, ID - BOI Boston Logan, MA - BOS Buffalo, NY - BUF Burbank, CA - BUR Charleston, SC - CHS Chicago (Midway), IL - MDW Cleveland, OH - CLE Columbus, OH - CMH Corpus Christi, TX - CRP Dallas (Love Field), TX - DAL Denver, CO - DEN Detroit (Metro), MI - DTW El Paso, TX - ELP Ft. Lauderdale/ Hollywood, FL - FLL Ft. Myers, FL - RSW Greenvile/Spartanburg, SC - GSP Hartford/Springfield, CT - BDL Houston (Hobby), TX - HOU Indianapolis, IN - IND Jackson, MS - JAN 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 Midland/Odessa, TX - MAF Milwaukee, WI – MKE Minneapolis, MN - MSP Nashville, TN - BNA New Orleans, LA - MSY New York (LaGuardia), NY - LGA Newark, NJ - EWR Norfolk, VA - ORF Oakland, CA - OAK Oklahoma City, OK - OKC Omaha, NE - OMA Ontario, CA - ONT Orange County, CA - SNA Orlando, FL - MCO Panama City Beach, FL – ECP Philadelphia, PA - PHL Phoenix, AZ - PHX Pittsburgh, PA - PIT Portland, OR - PDX Providence, RI - PVD Raleigh-Durham, NC - RDU Reno, NV - RNO Rio Grande Valley (Harlingen), TX - HRL 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, WA - SEA Spokane, WA - GEG Tampa, FL - TPA Tucson, AZ - TUS Tulsa, OK - TUL Washington (Dulles), DC - IAD West Palm Beach, FL - PBI Arrival City Choose Arriving City Albany, NY - ALB Albuquerque, NM - ABQ Amarillo, TX - AMA Austin, TX - AUS Baltimore/Washington, MD - BWI Birmingham, AL - BHM Boise, ID - BOI Boston, MA - BOS Buffalo, NY - BUF Burbank, CA - BUR Charleston, SC - CHS Chicago (Midway), IL - MDW Cleveland, OH - CLE Columbus, OH - CMH Corpus Christi, TX - CRP Dallas (Love Field), TX - DAL Denver, CO - DEN Detroit (Metro), MI - DTW El Paso, TX - ELP Ft. Lauderdale/ Hollywood, FL - FLL Ft. Myers, FL - RSW Greenvile/Spartanburg, SC - GSP Hartford/Springfield, CT - BDL Houston (Hobby), TX - HOU Indianapolis, IN - IND Jackson, MS - JAN 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 Midland/Odessa, TX - MAF Minneapolis, MN - MSP Nashville, TN - BNA New Orleans, LA - MSY New York City, NY [LaGuadia] - LGA Newark, NJ - EWR Norfolk, VA - ORF Oakland, CA - OAK Oklahoma City, OK - OKC Omaha, NE - OMA Ontario, CA - ONT Orange County, CA - SNA Orlando, FL - MCO Philadelphia, PA - PHL Phoenix, AZ - PHX Pittsburgh, PA - PIT Portland, OR - PDX Providence, RI - PVD Raleigh-Durham, NC - RDU Reno, NV - RNO Rio Grande Valley (Harlingen), TX - HRL 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, WA - SEA Spokane, WA - GEG Tampa, FL - TPA Tucson, AZ - TUS Tulsa, OK - TUL Washington (Dulles), DC - IAD West Palm Beach, FL - PBI * Student Classification Select one Freshman Sophomore Junior Senior Graduate Student Professional School OFFICIAL TRANSCRIPT
HACU requires that an official transcript be submitted
from the institution where you are currently enrolled.
Please note that your official transcripts,
along with your Certificate of Enrollment must be received by HACU before your
application is considered complete. Applications must be complete to be considered
for any award.
CERTIFICATION OF ENROLLMENT
Download the Certification
of Enrollment and Class Level form and have it completed by
an academic advisor, dean, registrar or other school official.
Please mail this completed form along
with your official transcripts by April 29, 2011:
¡Lanzate! Travel Award Program HACU National Headquarters
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
* What are your challenges in working toward higher education?
COLLEGE UNDERGRADUATE STUDENTS * If YES, answer the following question.
Yes
No If selected, how do you believe that obtaining travel on Southwest Airlines would benefit you and your family?
GRADUATE STUDENTS * If YES, answer the following question.
Yes
No How would the airline ticket(s) be used to help meet your goals as a graduate student? 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.) NOTE: 300 words NOT required.
PREVIOUS TRAVEL AWARD RECIPIENT * If YES, answer the following question.
Yes
No Please explain how the award was used and how it helped you and/or your family? (200 words) STUDENT CERTIFICATION
I hereby agree that Southwest Airlines Co. 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.
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 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 many provide to HACU, and/or
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)
