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ITAV Registration for August 2023 Workshops
We are pleased to offer free maternal and infant mortality health workshops. ITAV is a project that advocates of the high infant mortality rate among our Native Hawaiian Pacific Islanders (NHPIs) in Utah.
Please complete this form to register. If you are registering multiple people, please complete one form per person.
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First and Last Name
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Your answer
Age
*
Please note, participants must be 18 or older.
Your answer
Phone Number
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Your answer
Email Address
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Your answer
Please enter the Utah zip code that you currently reside in
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Your answer
Race/Ethnicity (Check all that apply)
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Fijian
Marshallese
Chamorro
Native Hawaiian
Maori
Tongan
Samoan
Other:
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By clicking this box, you are acknowledging that you are registering for the ITAV August Session held on Thursdays August 10, 17, 24, & 31. This program is offered free of charge for Native Hawaiian and Pacific Islander participants.
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