Skip to content
Search for:
PAF Home
WIRED Home
Apply
Resources
Sites & Data
Field and Lab Protocols
COVID info
Search for:
PAF Home
WIRED Home
Apply
Resources
Sites & Data
Field and Lab Protocols
COVID info
Wired – Apply 2022
webmaster
2022-04-19T20:39:47-10:00
APPLY to WIRED and Kilo Kai 2022
Name
*
First
Last
I am applying as part of:
*
WIRED
Kilo Kai - Marine Science Club, without request for WCC credit
Kilo Kai - Marine Science Club for WCC credit
Student's non-DOE email (personal gmail / not school issued)
*
please do not use your K-12 school email address.
Enter Email
Confirm Email
Phone Number
*
A good phone number to reach you
SMS Text phone number
*
The best number to use in case a text message is used in urgent situations.
Date of Birth
*
MM slash DD slash YYYY
Parent or Legal Guardian
*
First
Last
Parent or Legal Guardian Email
*
Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
School Information
What school do you attend?
*
Castle High School
Hakipu'u Learning Center
Hālua Kū Māna
'Iolani
Kahuku Intermediate
Kailua Intermediate
Kailua High School
Kalaheo High School
Kamehameha
Kaʻohao School
King Intermediate School
Kekula o Samual Kamakau Lab School
Punahou
SEEQS
Waimanalo Intermediate
Your Grade Level currently
6th
7th
8th
9th
10th
11th
12th
Who is your science teacher or advisor?
*
Emergency Contact
In the event of emergency, who would we be able to contact on your behalf?
Name of Emergency Contact #1
*
First
Last
Relationship
*
Phone
*
Mobile/Text Number if different from above
EMERGENCY CONTACT #2
optional
First
Last
Relationship
Phone
Mobile/Text Number
About You / Demographics and Coursework
I identify my gender as:
Female
Male
Non-binary or other
How do you identify your ethnicity (check all that apply)?
Native Hawaiian
Pacific Islander
Asian or Asian American
Black or African American
Caucasian (non-Hispanic)
Hispanic or Latino/a
Arab or Arab American
Native American or Aleut
Do you receive Special Education Services?
Yes
No
Are you interested in a Science Career?
Yes
No
I am unsure of my career interests
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.
Page load link
Go to Top