UH HILO Unclassified - Secondary Campus
Application Form
*Primary campus: Community College
*Financial Aid Source: Community College
*Secondary campus: UH Hilo
Who submits this form:
Students enrolled or planning to enroll at a community college campus in the University of Hawai‘i system who
wish to be admitted and eligible to take one or more courses concurrently through the University of Hawai‘i at Hilo.
PLEASE TYPE OR PRINT CLEARLY IN INK. COMPLETE THIS FORM AND SUBMIT IT TO THE ADMISSIONS OFFICE.
EMAIL OR FAX THIS FORM TO:
University of Hawaii at Hilo
Admissions Ofce
200 W. Kawili Street
Hilo, HI 96720-4091
uhhadm@hawaii.edu
Fax: (808) 932-7459
SEMESTER & YEAR ENTERING
Fall _____________ Spring ______________
Community College Home Campus _______________________________________________
UH Hilo | UNCLASSIFIED | SECONDARY CAMPUS
UH ID Number or
UH username
Legal Name: Last First MI Birthdate (mm/dd/yyyy)
/ /
Current Mailing Address: Street City/Province State/Country Postal Code
Mailing Address Valid Until (mm/dd/yyyy)
/ /
Phone Number
( ) -
Email Address
Permanent Address: Street City/Province State/Country Postal Code
By entering your name here, you agree that it is the same as your signature.
Signature ________________________________________________________________________________
Date (mm/dd/yyyy)
/ /
click to sign
signature
click to edit