Kapolei High Driver's Education Program SY 17-18
Your completed form will be time-stamped, acceptance is based on first-come-first-serve basis. We can accommodate 30 students per session with 5 sessions per year.
Disclaimer: Please include active email addresses and functioning phone #'s, we are experiencing difficulties trying to contact individuals with non-functioning phone #'s and inactive emails.

One month before the start of each session, we will make 3 attempts to contact you either through your email or phone #.

Email address *
Student Name (last, first) *
Birth Date (month/day/year) *
Gender *
Home Address *
Current Driver's Permit #
Date permit expires (month/day/year)
County that permit was issued? *
Student Phone Number *
Mother's/Legal Guardian Name (last, first) & phone # *
Father's/Legal Guardian Name (last, first) & phone # *
Home Phone Number *
E-mail address (check email often) *
What school are you currently attending? *
Current grade or last completed grade. *
Which session do you want to attend? (All entries are first-come-first-serve, you will be informed of the session you are in, at least 2 weeks prior to the orientation meeting) Sorry but sessions 1, 2, 3 & 4 are full and closed. *
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