Kingdom of Hawai’i Declaration Form
SECTION I: Student Information
Student Name: _________________________________________________ ____ Student ID: ____________________________
Email Address: _____________________________________________@hawaii.edu Phone: _______________________________
SECTION II: Changes to student personal data
I, _____________________________________________________________________________________________
Last Name First MI
do hereby declare that I would like the University of Hawai‘i to designate my affiliation with the “Kingdom of Hawai‘i” in the student
information system.
SIGNATURE: ______________________________________________________ DATE: __________________________
FOR OFFICE OF THE REGISTRAR USE ONLY:
Revised 02/2018
SPAPERS Date: _______________ Initial: ______________
Office of the Registrar / 200 West Kawili St. Hilo, HI 96720-4091 / Student Services Center, First Floor Rm 101 / Phone: (808) 932-7447 / Fax: (808) 932-7448 / E-mail: uhhro@hawaii.edu
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