Fillable Kahua Hoomau Ola oha, Al Thank you for (Leeward Community College)

Fill Online, Printable, Fillable, Blank Kahua Hoomau Ola oha, Al Thank you for (Leeward Community College) Form

Use Fill to complete blank online LEEWARD COMMUNITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Kahua Hoomau Ola oha, Al Thank you for (Leeward Community College)

On average this form takes 18 minutes to complete

The Kahua Hoomau Ola oha, Al Thank you for (Leeward Community College) form is 4 pages long and contains:

  • 2 signatures
  • 37 check-boxes
  • 47 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Leeward Community College

BROWSE LEEWARD COMMUNITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Kahua Hoʻomau Ola
“ʻO ke kahua ma mua, ma hope ke kūkulu”
Foundation first, then build.
~ʻōlelo noʻeau #2459
Al
oha,
Thank you for your interest in the Kahua Hoʻomau Ola Program at Leeward Community College. We hope that
this unique program will encourage you to consider college. Below is some general information. If you have any
other questions about the project or the enrollment process, please call Leilani Puchalski at 455-0242 or email:
dianelp@hawaii.edu.
Ab
out the Kahua Hoʻomau Ola Project
The Kahua Hoʻomau Ola project is a very special program funded by a generous donor allowing Oʻahu residents an
opportunity to try college for free. Of course, it will cost you time and commitment. The program provides
scholarships and academic support to participants to attain certificates or an associate degree at Leeward
Community College or just to try taking a few college courses! If you have not considered a college education
because of financial or other constraints, this may be the program for you!
Priority consideration is given to applicants who:
• have no previous college experience or intent to enroll in college
• who are of Hawaiian ancestry
• who demonstrate that there are financial and other barriers to enrolling in college
• who demonstrate in the application that they would not be able to attend college without the
scholarship.
Applying to KHO
The completed application should be signed and dated and submitted 1) by mail or in person to Leeward
Community College or 2) by email to dianelp@hawaii.edu. The enrollment application is attached to this letter.
Le
eward Community College
Attn: Leilani Puchalski, Kahua Hoʻomau Ola
96-045 Ala ʻIke
Pearl City, HI 96782
Referral Form
Kahua Hoʻomau Ola is a referral based program. It is highly recommended that you have a referral form completed
and submitted by somebody who knows you i.e. counselors, advisors, teachers, employers, case manager etc.
Mālama pono,
The Kahua Hoʻomau Ola Program team
Kahua Hoʻomau Ola
“ʻO ke kahua ma mua, ma hope ke kūkulu”
Foundation first, then build.
~ʻōlelo noʻeau #2459
Fall 2020
Student Application
The Kahua Hoʻomau Ola Program at Leeward Community College is a unique program whose purpose is: “To expose
students to the essential values and habits that are intrinsic to an environment of higher learning and that, over
time, contribute to career, academic and personal success.” The program provides scholarships and academic
support to Oʻahu residents who would not otherwise have considered taking classes at the college level OR who
would not have been able to take classes at the college level. Students accepted into the program must be a state
resident as determined by the UH common application. This form should be signed and dated and submitted 1) by
mail or in person to Leeward Community College or 2) by email to dianelp@hawaii.edu.
A PPLICANT I NFORMATION
(please print)
Name
Last, First, MI
Previous names
(maiden, etc.)
Preferred name
Address 1
Street
Address 2
Apt #
City
Zip Code
Email
Phone number
Alternate phone
number
Birthdate
How did you hear of
Kahua Hoʻomau Ola?
Name of person submitting Referral Form on your behalf? __________________________________
Relationship to you: (please circle/ check)
name
o Counselor
o Teacher
o Advisor
o Other:__________________________
o Yes
o No
Kahua Hoʻomau Ola
“ʻO ke kahua ma mua, ma hope ke kūkulu”
Foundation first, then build.
~ʻōlelo noʻeau #2459
H IGH SCHOOL E DUCATION
Name of high school
attending/ attended
Did you graduate?
(please circle/ check)
o Yes
Graduation date
o No
• I will graduate on ___________________
or
• I earned by GED from ___________________ on ____________
date
While in high school, did you take college classes including Early College or Running Start? If so what class(es) did you
take, what was your final grade and year enrolled (9th grade, 10th grade, 11th grade, 12th grade)?
• Name of class__________________ Final grade________________ Year enrolled________________
• Name of class__________________ Final grade________________ Year enrolled________________
• Name of class__________________ Final grade________________ Year enrolled________________
While in high school, did you take any AP classes? If so what class(es) did you take, what score did you earn on the exam,
and when did you take the class? (9th grade, 10th grade, 11th grade, 12th grade)?
• Name of class__________________ AP exam score________________ Year enrolled________________
• Name of class__________________ AP exam score________________ Year enrolled________________
• Name of class__________________ AP exam score________________ Year enrolled________________
Do you qualify for free or reduced lunch? (check one). Free Reduced
Does your household receive any public assistance? (check all that apply)
SNAP TANF WIC Section 8 Other:________________________
L IFE EXPERIENCES
You were nominated because of your special life experiences. Please check all that apply as it pertains to you.
o Child of a single parent household
o Sole provider/ caregiver for family member (child, younger sibling, aging parent)
o Former foster youth
o One or both parents are deceased
o Currently receiving public assistance benefits
o Previously incarcerated
o Parent(s) currently incarcerated
o Completed (or currently completing) a parole contract, addiction treatment program, or other court mandated program
o Dropped out of high school, earned GED
o Houseless/ Housing Insecure
o Ward of the state
o Working 30+ hours per week
o Parents/ Guardians never went to college
o First person in your family to go to college
o Was told by someone NOT to go to college or I would not be successful in college
o Other:__________________________________________
Kahua Hoʻomau Ola
“ʻO ke kahua ma mua, ma hope ke kūkulu”
Foundation first, then build.
~ʻōlelo noʻeau #2459
C OLLEGE
Have you ever previously attended or are currently attending
college or a university?
_________YES _________NO
If yes, please complete:
Name of college:______________________
Dates: From___________ to ____________
Total credits earned/ will earn:___________________
Have you applied for or are planning to apply for a
summer program that introduces you to college?
(i.e. ʻOnipaʻa at UHWest, Pasefika Passion Pipeline 3P, etc.)
_________YES _________NO
Are there barriers that prevent you from going to college?
_________YES* _________NO**
*If yes, please describe all the barriers that will prevent you from going to college. It is important to explain ALL the barriers
to help us understand your situation.
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
**If no, please describe why you are applying for Kahua Hoʻomau Ola. How will being a part of Kahua Hoʻomau Ola help you
reach your goals?
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Appli
cant’s Signature: Date:
If applicant is a minor, Parent/ Guardian Signature: Date:
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Kahua Hoomau Ola oha, Al Thank you for (Leeward Community College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 3 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document