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Sign up for Nutrition & Life Skills Classes with EFNEP and SNAP-Ed
Thank you for your interest in the nutrition and life skills classes with EFNEP and SNAP-Ed!
Please fill out the form to the best of your ability. A staff member will contact you as soon as we can. If you have any questions please call our office at (808) 956-4124 or email at hnctr@hawaii.edu
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* Indicates required question
Name
*
Your answer
Phone number
*
Your answer
Are you able to receive text messages from this phone number?
*
Yes
No
Do you have an email address?
*
Yes
No
Please provide your email address. If you do not have an email address please type in "N/A"
*
Your answer
What would be the best way to contact you? Check all that apply.
*
Phone call
Email
Text
Required
Please type in the total number of children you have or care for.
*
Your answer
Please type in the ages of the children.
*
Your answer
Do you and your family participate in the following Public Assistance Programs? Please check all that apply.
*
Children nutrition (free & reduced lunch)
FDPIR
Head Start
SNAP
TANF
WIC
Food pantry/Foodbank
Job Corps
Medicaid/MedQuest
Supplemental Security Income
Transitional Housing/Shelter
Do not participate in Public Assistance Programs
Other:
Required
How did you hear about EFNEP nutrition classes? Please check all that applies.
*
Flyer
Word of mouth
Community organization
Presentation
Website
Food pantry/Foodbank
Community or Health Fair
Other:
Required
Adult classes are offered virtually. Do you have a device (e.g. laptop, iPad, tablet, phone) to recieve these classes virtually?
*
Yes
No
Please indicate your availability to meet.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
9:00 - 10:00 am
10:00 - 11:00 am
11:00 am - 12:00 pm
1:00 - 2:00 pm
2:00 - 3:00 pm
3:00 - 4:00 pm
5:00 - 6:00 pm
6:00 -7:00 pm
7:00 - 8:00 pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
9:00 - 10:00 am
10:00 - 11:00 am
11:00 am - 12:00 pm
1:00 - 2:00 pm
2:00 - 3:00 pm
3:00 - 4:00 pm
5:00 - 6:00 pm
6:00 -7:00 pm
7:00 - 8:00 pm
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