HETS Application Form Institutions benefits SPANISH Rev Feb-11

PO Box 21345 San Juan, PR 00928-1345 T: 787.766.2600 X. 8910, 8911 W: www.hets.org
Help build a brighter future for Hispanic communities everywhere by joining HETS. Please provide information
requested on this form and send it to the address above or by fax (787) 250-8546. Your application will be received at
the HETS Headquarters to proceed with your membership. Once the designated staff evaluated your application,
you will be receiving a confirmation of acceptance with detailed information about how start enjoying your benefits.
Name: ____________________________________________ Type of Institution(select all that apply):
____ Degree Granting Institution ____ Non Degree Granting Institution
____ Community College ____ Four-Year College/University
____ University System ____ Educational Institute
____ High School ____ Other: ___________________________________________
Is your college, university, or institute a Hispanic-Serving Institution? ____Yes ____ No
Number of students enrolled ___________ Percent of Hispanic students (If applicable) _____
Distance Learning
1. Does your institution offer distance learning opportunities? _____ Yes _____ No
a. If not, are you interested in distance learning? _____ Yes _____ No
b. If yes, what is the distance learning modality used at your institution?
____ Videoconference ____ Online/Web-based ____ Other:_____________________
2. Type of Distance Learning offerings
____ Online Courses ____ Online Programs
____ Hybrid Courses ____ Distance Learning under development
3. Is there a distance education coordinator or director at your institution? ____ Yes ____ No
a. If Yes: Name_________________________ Title: __________________________________________
b. Telephone_________________ Fax_______________ Email __________________________________
Urgent needs of your Institution (choose all that apply)
____ Faculty Capacity Building ____ Distance Learning/ Educational Technologies Advising
____ Student Support Services Online ____ Retention strategies
____ Assessment of learning outcomes ____ Collaborative Grants
____ Infrastructure ____ Network with peers
____ Other: ____________________________________________
Institutional Contact Information
Name of President/Chancellor: ____________________________________________________________________
Institutional Address: _______________________________________________________________________________
___________________________________________________________________________________________________
Designated Institutional Contact person for HETS
Name____________________________________ Title: _________________________________________________
Telephone _________________ Fax ____________ E-mail______________________________________________
Submitted By: ______________________________ (Name), __________________________ (Title) ______________________ (Date)

Differences between Full Membership and Affiliated Membership
Membership Benefits Founding/Full Members
Circle the type of membership requested
(1= indicated the benefit that applies)
4-year
C's & U's
Community
Colleges
Could be an elected Board Member 1 1
International Members/ Affiliated Members
Associate Members/
International Members
4-year C's Community
& U's Colleges Institutes
Submitted By: ______________________________ (Name), __________________________ (Title) ______________________ (Date)
High
Schools
5,000.00 3,000.00 2,500.00 1,500.00 2,500.00 $1,250.00
Participation in specific committees and task forces 1 1 1 1 1 1
Collaborative Grants 1 1
Grant writing project management 1 1
Special discount rate to services and events 1 1 1 1 1
Discount fees for faculty training and support 1 1 1 1 1 1
Access to Virtual Plaza standard services 1 1 1 1 1 1
Access to Virtual Plaza deluxe services (e.g., Testing &
Education Reference Center, e-Books, etc.) 1 1 1 1 1 1
Use of HETS portal to promote DL courses and
programs 1 1 1 1 1 1
Participation in online learning and support services
projects 1 1 1
Access to bilingual online learning tools and student
support services 1 1 1 1 1 1
Access to state-of-the-art collaborative technology
services and products at special discounts, group
rates, or price splits 1 1 1
Access to market data on Distance Learning 1 1 1 1 1 1
Receive the HETS CONNECTION (members-only enewsletter
with latest information and innovative
resources) 1 1 1 1 1 1
Guidance and Advising in Distance Learning and
Educational Telecommunications 1 1 1 1
Networking with a culturally diverse community of
academic, business and professional organizations 1 1 1 1 1 1
Opportunity for e-Marketing 1 1 1 1 1 1
Promotion of Institutional Projects 1 1 1 1 1
Participation and access to institutional surveys 1 1 1 1 1 1
Information Resources 1 1 1 1 1 1
Opportunity to submit articles to the HETS peer review
Journal 1 1 1 1 1
Opportunity to reach thousands of contacts through
HETS email campaigns 1 1 1 1 1 1
Free web hosting for institutional and collaborative
project dissemination 1 1
Participation in efforts for new grants and funding
resources for innovative distance learning programs 1 1
Public Exposure 1 1 1 1 1 1
President's Caucus 1 1
Number of Benefits 26 26 17 17 20 16
1