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Purple Maia Foundation
Registration for Makalii Courses (December 2022)
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Parent / Guardian First and Last Name
*
Your answer
How would you rate your childʻs abilities to use and work on a computer independently?
*
Could use improvement
1
2
3
4
5
Extremely independent
Child Age (If you are registering more than one student you may select multiple boxes)
*
9
10
11
12
13
14
15
16
17
Other:
Required
Child First and Last Name (If listing more than one student please put a comma in between names)
*
Your answer
What school does your child attend? Please include island (example: Kailua Intermediate - Oahu)
*
Your answer
What ethnicity does your child identify with the most? (please select one)
*
White/European
Native Hawaiian
Pacific Islander
Filipino
African/Black
East Asian
Native American
Latinx
Other:
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