2020LooChoo Identity Summit (LIS) Registration Form
March 6-7 @ Windward Community College in Kaneohe and March 8 @ Pagoda Restaurant Ballroom in Honolulu
Email address *
First Name *
Your answer
Last Name *
Your answer
Ancestral Family name (eg.Nakaganeku/Nakamura, Fija/Higa)
Your answer
Mailing Address (line 1: house number, street name or PO Box number) *
Your answer
Mailing Address (line 2: City, State, Zipcode) *
Your answer
Contact Phone Number (area code + 7 digit) *
Your answer
If you require special provisions (ADA), please describe accommodations needed:
Your answer
Any Okinawan affiliations (e.g. clubs, music/dance groups, schools)?
Your answer
What’s your ancestral Ryukyuan village(s)?
Your answer
Registration Fees (check one): *
Preferred Payment option (check one) *
Payment Information:
Personal check: Please make payable to Ukwanshin Kabudan and mail to: Ukwanshin Kabudan, PO Box 892725, Mililani, HI 96789

credit card: An invoice will be sent to you via email to allow you to securely enter your credit card payment.
Any comments or concerns?
Your answer
Ippē Nifē Dēbiru! Thank you for your interest and support.
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