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So that HECUA can better serve you, we'd like to know who you are.

I am (check all that apply)...

an undergraduate student (HECUA programs are not designed to support high school students or post-graduate students)

a faculty member

a staff member at a college/university

a parent of a perspective student

a community partner/member

an internship site

a donor

First Name *

Last Name *

Address *

City / State / ZIP *

Phone Number *

Email *

I would prefer to be contacted by:

phone

email

phone and email

just by mail

The best time to reach me is between:

9 a.m - 11a.m.

11 a.m. - 1 p.m.

1 p.m. - 3 p.m.

3 p.m. - 5 p.m.

Additional information. Please fill in all that apply...

School / Organization affiliation

Department

Graduation year

Major/Minor

Intended year to study off-campus

Intended term to study off-campus

How did you hear about HECUA? *

What programs most interest you and why?

PROGRAMS THAT INTEREST ME:

BANGLADESH

Development and Community in Bangladesh — J-Term

ECUADOR

Community Internships in Latin America — Fall & Spring Semester 

Social and Political Transformation in Ecuador — J-Term

NORTHERN IRELAND

Democracy & Social Change — Spring Semester

SCANDINAVIA

Scandinavian Urban Studies Term — Fall & Spring Semester

U.S.A.

City Arts — Spring Semester

Civil Rights Movement — Summer Term

Environment and Agriculture — Summer Program

Environmental Sustainability — Fall Semester 

MUST: Poverty, Inequality, and Social Change — Fall & Spring Semester

Writing for Social Change — Fall Semester

Also include...

All international sites

All U.S. programs

Short-term programs only (January-term and summer)

What would you like us to mail you (check all that apply)?

Program guide

Individual program info (based on the programs you identified above)

Most recent newsletter

Student application

Host an intern information kit

Donor information

By submitting this form, you accept the Mollom privacy policy.

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Higher Education Consortium for Urban Affairs (HECUA)
2233 University Avenue West, Suite 210
Saint Paul, MN 55114
hecua@hecua.org
(651) 287-3300 - general number
(651) 287-3319 - student services
(651) 659-9421 - fax

HECUA is a 501(c)(3) nonprofit organization
© Copyright 2011 HECUA