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In order to begin the CHCI online application process you will need to take the following steps: 


Step One:       Disable your computer’s “pop-up” blocker setting for the CHCI application 
                        website on your internet browser

                       Once you click the continue button after filling out the personal profile, there is a 
                        pop up message and you must confirm your information before you can proceed

Step Two:       Complete your personal profile
                       General information about yourself

Step Three:    A verification email will be sent to the email address you listed 
                        on your personal profile
                        Once you have clicked on the email link and verified your account, you may log into the 
                        online application system and continue the application process

Step Four:      Proceed to filling out the CHCI program-specific application
According to the information you have filled out on your personal profile, the system 
will inform you what you are eligible to apply for                       

Note: Red asterisks (*) signify required responses




PERSONAL INFORMATION
 *
Middle Name 
 *
 * Male   Female
 *  -   - 
 *  )  -   - 
Secondary Phone   )  -   - 
PERMANENT ADDRESS (Home Address)
 *
 *
Apt/Unit/Other
 *
 *
 *
CURRENT ADDRESS
 Is your current address the same as your permanent address
 *
 *
Apt/Unit/Other
 *
 *
 *
BACKGROUND INFORMATION
 *
 African-American
 American Indian
 Argentinean
 Asian/Pacific Islander
 Bolivian
 Brazilian
 Caucasian
 Chilean
 Colombian
 Costa Rican
 Cuban
 Dominican
 Ecuadorian
 Guatemalan
 Honduran
 Mexican
 Nicaraguan
 Other 
 Panamanian
 Paraguayan
 Peruvian
 Puerto Rican
 Salvadoran
 Spaniard
 Uruguayan
 Venezuelan
What is your place of birth? 
 *
 *
 *
 *
EDUCATIONAL INFORMATION
 *
 *
 
 
 Associate's
 Bachelor's
 Advanced Degree (Masterís, JD, PHD, MD, other)
 Not currently enrolled in College or Advanced Degree Program (Master's, JD, PHD, MD, other)
EMERGENCY CONTACT INFORMATION
 *
 *
 *  )  -   - 
 *
 Yes, I would like to receive e-mail from CHCI
Are you a past CHCI Program Participant? Yes   No
 * Website
Guidance Counselor/Academic Advisor
Magazine/Newspaper Ad
CHCI Representative
Student Organization
Former CHCI Participant
Educational Institution
Radio
Email
College Campus Presentation
LOGIN
 *
 *
 *
 *
* Required Fields


Important: By filling out the profile, you have not applied for a CHCI Program. To continue the application process you must receive a verification e-mail and log back into apply.

Orchestrate Application System