HELA program staff will not release this information without your prior consent. See Confidentiality and FERPA notice at the end of this form.
(Last, First, Middle)
UH ID Number *
UH Email *
Phone Number *
Street Address *
City, Island, State *
Zip Code *
Were any of your ancestors Native Hawaiian? *
What type graduate degree program are you pursuing? *
What program are you pursuing? *
When you do anticipate completing your degree program? (e.g. Fall 2024) *
Are you proficient in reading, writing, and speaking Hawaiian?
Although academic excellence is important, we are also interested in learning more about you and your connections, activities, and contributions in the community. In 250 words, please describe some influential experiences that have transformed your personal and academic life. *
Please tell us about yourself, where do you come from? What are your interests? What motivated you to pursue a graduate degree? What does kuleana mean to you? How does it relate to you pursuing higher education? How will completing your degree benefit your family, community, and the lāhui? *
University of Hawaiʻi, Mānoa - 2022 COVID-19 Mandatory Vaccination for Students Policy Acknowledgement
Effective January 3, 2022, the University is requiring that all Students be Fully Vaccinated against COVID-19 prior to entering any University campus or any University facility or office (collectively, "University Site"), subject to the following provisions and exemptions. Nothing in this policy is intended to alter or excuse University requirements for in-person attendance relating to education or employment.
Please certify that you have read and understand the University of Hawaiʻi, Mānoa - 2022 COVID-19 Mandatory Vaccination for Students Policy.
I have read and understand the University of Hawaiʻi, Mānoa - 2022 COVID-19 Mandatory Vaccination for Students Policy. *
Confidentiality & FERPA
The information provided in this application is for the sole use of the Hilinehu: Education Leadership Advancement Program team to ensure program eligibility and provide student support assistance. As such the information provided will be kept confidential under the Family Educational Rights and Privacy Act of 1974 (FERPA) that forbids the disclosure of student information to any other party without first obtaining the written consent of the student.
Certification & Submission
(1) I certify the information submitted in connection with my Hilinehu: Education Leadership Advancement Program Application is complete and accurate. (2) I understand and commit to the fulfillment of the requirements listed in the Hilinehu: Education Leadership Advancement Program Expectations section of the application.
Signature (Type name to serve as signature) *
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