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Donor Choice #96270
SAT/COMPASS/SSAT Registration
Enroll me in the:
Please Select One
8/23-10/25 Kamehameha Schools Hawaii Campus SAT Prep
10/4-10/11 Waiakea High School SAT Prep
9/16-10/30 Pahoa High & Inter. SAT Prep
10/4-10/11 CCH SAT Prep (tuition required)
11/6-12/11 Pahoa High & Inter. COMPASS Prep
Student Last Name:
Student First Name:
Mailing Address:
City:
State:
Zip Code:
Home Phone:
Student Alternate Phone:
Student Email Address:
Student's School:
Student's Date of Birth (two digit month/day/year):
Graduation Year:
Please Select One
2008
2009
2010
2011
2012
Gender:
Please Select One
Male
Female
Ethnicity:
Please Select One
Asian
Black
Hawaiian
Hispanic
Native American/Alaskan
Pacific Islander
Filipino
Other
Household Income
Please Select One
Below $29799
$29800-$47679
Above $47680
Parent(s) Name:
Parent Work Phone:
Parent Alternate Phone:
Parent Email Address:
Emergency Contact:
Relationship:
Emergency Contact Phone:
Emergency Contact Alternate Phone:
Are you enrolled in College Connections NHSP?
Please Select One
No
Yes
Will apply to NHSP? (must attend DOE School and show Hawaiian ancestry on birth certificate)
Please Select One
No
Yes
Do you receive Free or Reduced-Price Lunch?
Please Select One
No
Yes
How did you hear about CCH?
How did you hear about CCH?
Yellow Pages
News Article
Television
Radio
High School Counselor
Web Search
Friend/Family
Other
Payment Method:
Payment Method:
I will PAY ONLINE using a CREDIT CARD or PAYPAL account
I will MAIL in my CHECK or MONEY ORDER
I will CALL to pay by CREDIT CARD
I am a NATIVE HAWAIIAN SCHOLARS PROGRAM (NHSP) participant
My tuition is FREE for SAT prep and COMPASS prep classes (Hawaii Island students only)
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By clicking the submit button, you agree to the following terms: In the event of a medical emergency, if the parent/guardian cannot be promptly reached, I authorize College Connections Hawai'i to contact 911 and initiate emergency services for this student. I authorize College Connections Hawai'i to use the name/video/photo of this student at any time or in any manner, in connection with its advertising or publicity. No further claim will be made by me/us. Registration will be complete when payment is received. Submitting this form does not guarantee enrollment. All prices and schedules are subject to change without notice. If students cannot be accommodated, payment will be returned. Any cancellations must occur by the first scheduled day of class. Attendance at the first class meeting is mandatory. Students who do not attend the first class, or notify CCH office staff of their absence, will be dropped from the class. Students may be disenrolled at the instructor's discretion, and partial refunds are not given.
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