Hispanic Theological Initiative

Creating and Nurturing a Community of Latina and Latino Scholars
Through the Combined Efforts of the Consortium Member Schools.

Student Contact Form

Enrollment as an HTIC Scholar is initiated by your institution. The information you provide in this form will help us to establish a direct line of communication, as well as to know more about your interests and academic status. After filling in the fields below, press the NEXT button.

*Last Name(s):
 
*First Name:
 
Middle Name:

*Gender:
 
*Ethnicity:  
*Denomination:  
*Marital Status:  
Department:
Specific Field:

Contact Information

 

Current Mailing Address

 
*Full Street Address (including PO box):
 
Street Address (Line Two):

*City:
 
*State:
 
*Zip/Postal code:
 
*Home Phone:
 
*Work Phone:
 
*Cell Phone:
 
*Email:
 
Permanent Contact Information (if different from above)  
Full Street Address (including PO box):
Street Address (Line Two):
City:
State:
Zip/Postal code:
Home Phone:
Work Phone:
Cell Phone:
Email:
Bio information: Please type a short bio (one or two paragraphs) including reasons why you decided to pursue Ph.D. Studies, area of interest, goals after graduation, and any other relevant information.