Application Form: ESCALA Moving Towards Serving Program

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Thank you for your interest in the Moving Towards Serving Mini-Course for HSI Practitioners.

Please fill out the following Application Form. For your application you'll need your HSI's current data around Latinx student enrollment, graduation, a list of your team members' names and roles, and the reasons for enrolling your team in the course.

The information you submit here will only be reviewed by our internal team of facilitators and HSI coaches. Your information will help us figure out who we will accept into the first round of the program. Your answers will also help us to make decisions about which of our coaches can best help you achieve your team's goals.

If you are filling out this Application, we will assume you are, for now, your team's coordinator and main contact for our program. You may change your role once the course starts. If your HSI team is accepted into the course, we will ask you to notify your identified team members to register for the course in ESCALA's Canvas course space. This way everyone will receive important announcements from us without you having to coordinate them. At that time you may also add additional team members.

We will alert you to your acceptance or a 'wait list' status no later than November 15, 2021. You will be notified at the primary and secondary contact emails you provide in your application.

Email *

Please provide a secondary email different from the one above, so that we can send you a confirmation of your application, and notification of your acceptance or wait list status on November 15.

How did you hear about the Moving Towards Serving program? *

What is the full name of your Hispanic Serving Institution? *

What is the city, state of your HSI? *

Is your HSI: *

Two year, public institution

Four year, public institution

Four year, private institution

Other:

When did your institution become an HSI? Do you have any idea of how it became an HSI (ie, whether it was an intentional recruitment of students, happened without planning, or historical HSI)? *

What percent of your undergraduate FTE is Hispanic/Latinx identifying? *

In the last few years is your percentage of Hispanic/Latinx identifying students growing, relatively steady, or decreasing? *

Growing

Relatively steady

Decreasing somewhat

Not sure

What are the graduation rates or transfer rates of your Hispanic/Latinx students (please indicate which you are reporting--graduation or transfer). How does this compare to the percent graduation or transfer rates for "All Students?" *

Is the graduation rate of your Hispanic/Latinx students growing, steady, or decreasing? *

Growing

Relatively steady

Decreasing

Not sure

What type of grants does your HSI currently have awarded to support your team's work? *

No grants are supporting our work at this time.

HSI-STEM

DHSI

HSI-NSF

Other:

Which of the following resources does your HSI currently have institutionalized, ie, is a program not funded by a grant? (check all that apply) *

Center for Teaching and Learning (may have a different name)

Diversity and Inclusion Director/Office

HSI Programs or Initiatives Director/Office

Services for Latinx student success (could have many names)

Other:

Required

Identify two current problems your campus is facing in relation to improving Latinx student outcomes. *

What big questions does your team have about how to make progress towards serving Hispanic and Latinx students? *

List the members of your team that you anticipate attending this program, with their departmental role within the team. For example: Janet Leigh, Institutional Effectiveness Researcher *

What outcome would your team like to have as a result of their participation and engagement in this course? (think of a program, webpage, or other tangible aspect of your team's work that aligns with your grant) *

What have we missed about your story? Please write in anything other information that we have not asked that you would like to share with our review team.

Please click submit and you'll receive a copy of your application. If you have any questions or need to modify your application please contact us at escalaeducation@gmail.com.

A copy of your responses will be emailed to the address you provided.

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