El Centro Student Referral Form

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Please fill out our student referral form and a member of El Centro will contact the student. If you have any questions, please email our service account elcentro@hcc.edu

El Centro aspires to provide a Hispanic thriving learning community to meet the needs of Latinx students. We connect with prospective and enrolled students and develop empowering relationships in support of their academic achievement, cultural belonging, and educational advancement.

Student First Name *

Student Last Name *

Student ID Number

Student Email *

Student Phone Number

Student's Preferred Method of Contact

Phone

Text

Other:

Student Intended Major

Reason for Referral *

Your Name *

Department *

Is student aware that you are referring them to El Centro? *

Yes

Notes

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