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Application for Lift HI Foundation Training
We are so happy you are interested in applying for training with Lift HI Foundation!  This application form should take no more than 5-10 minutes to complete.  We will be in touch with you no more than 3 business days after we receive your application.  

You can check our website - www.lifthi.org - for more information about us and our upcoming trainings dates!   

Don't let anything get in your way of getting in touch with us.  If you have any questions or concerns, please call or text Lift HI Foundation at 808-583-7418 or email us info@lifthi.org.  We look forward to talking to you soon!  
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First Name *
Last Name *
Name you prefer to be called *
Mobile Phone Number (Area Code & Phone Number) *
Email Address *
Mailing Address (Street & Apt, City, Zip Code) *
How do you prefer to be contacted?   *
Are you a resident of Jack Hall Waipahu, Waipahu Towers, River Pauahi, Smith Beretania, or Queen Emma Apartments?  *
How did you hear about our training program?  *
Are you currently working (employed or self-employed)?   *
Have you worked in the last 12 months (employed or self-employed)?   *
I currently fall into the following age bracket: 
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Do you have a high school degree or high school equivalent degree (e.g. GED)? *
Do you have the legal right to work in Hawai'i?  *
My total household income (including wages, self-employment income and government assistance) is... *
My household (the people I live with on a day-to-day basis) has:  *
My racial background is...(Check all that apply) *
Required
Do you have experience with caregiving? (Check all that apply.)  *
Required
Is there anything else you would like to share?   *
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