Join Us

Be a part of change with Kinai ʻEha

Join Kinai ʻEha

Are you a parent, member of a nonprofit organization, or high school staff member interested in enrolling your haumana in Kinai ʻEha?

FIll out the secure application below, and one of our staff members will contact you shortly regarding your application. When applying, please remember to include:

– A scanned or digital copy of the student’s ID
– A scanned or digital copy of the student’s medical card

Student Information
Student's Name*
First Last
Student's Date of Birth*
MM slash DD slash YYYY
Last Four Digits of Student's Social Security Number*
XXX-XX-
Current Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Parent/Guardian/Sponsor Information
Sponsor Name*
First Last
Relationship to Student*
Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Email Address*
Required Documents
The documents collected below are used for the sole purpose of processing applications for Kinai 'Eha. Please note that copies of the following documents are required to complete the application. If you choose not to submit these documents electronically, you will be asked to submit them in person.
Copy of Student ID
Accepted file types: jpg, pdf, png, tif, Max. file size: 300 MB.
Copy of Student Medical Card
Accepted file types: jpg, pdf, png, tif, Max. file size: 300 MB.
Copy of Student Social Security Card
Accepted file types: jpg, pdf, png, tif, Max. file size: 300 MB.
Copy of Student Birth Certificate
Accepted file types: jpg, pdf, png, tif, Max. file size: 300 MB.
Submit Application
Consent*
I agree to the Kinai 'Eha privacy policy.
Information will be collected and stored for the sole purpose of processing applications for Kinai 'Eha. Your information will not be publicized or provided to any third-party agencies without your consent.
Signature

Contact Kinai ʻEha



(808) 489-4003



Kawailoa Youth & Family Wellness Center, Bldg. 8,
42-470 Kalanianaole Hwy,
Kailua, HI, 96734



admin@kinaieha.org

Home | About | Join Us | Contact

Join Us

Join Kinai ʻEha

Student Information

Parent/Guardian/Sponsor Information

Required Documents

Submit Application

Contact Kinai ʻEha