Training Registration Form

Career Kokua Training Registration Form

(One form per person)

Print this form, fill in the requested information and deliver or fax to: Career Kokua @ 830 Punchbowl St., Rm. 415 @ Honolulu, HI 96813 @ Fax: 808-587-5522

Name & Title:

School/Agency:

Address:

Email:

Tel:

Fax:

Workshop(s) attending:

Island/Location:

Workshop:

Date:

Island/Location:

Workshop:

Date:

For workshops on Oahu, please check here if you will need a parking pass and will remit $5: