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Last Name
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First Name
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Have you previously enrolled in any college courses?
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Have you previously enrolled in any UH campus in the past?
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Where are you currently employed?
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Kaiser
Hale Makua (Maui)
ʻOhana Pacific Health (Oahu)
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Hale Kupuna (Kauai)
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Have you completed any of the following courses?
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Math 75X or higher (e.g. Math 115?)
ENG 22 or ENG 100
PSY 100
PHRM 203
BIOL 100
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What contact number would you like us to call to schedule an appointment? (xxx) xxx-xxxx
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