The Change Academy 2019 Application Form
The Change Academy 2019 Application Form

Application deadline: May 30, 2019 5pm (Hawaii Standard Time) 

Inquiries: info@lokahi-foundation.org

Web Site:https://www.lokahi-foundation.org/
Facebook: https://www.facebook.com/TheChangeAcademyHawaii/
Instagram: @TheChangeAcademyHawaii

Name (First Name) *
Name (Middle Name)
Name (Last Name)
Nickname
Gender *
Birthday (Month-Day-Year) *
MM
/
DD
/
YYYY
Email Address *
Phone number
School *
Grade (as of April 2019) *
Mailing Address *
How did you hear about The Change Academy? *
Any dietary restrictions and/or medical condition(s) that we should be aware of?
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