Affordable English School in Hawaii | Central Pacific College

Club Keiki Application

We are no longer accepting applications for the 2019 Spring/Summer Kids Program (Club Keiki).

A total of 75 people from 6 countries/regions (Japan, Korea, China, Taiwan, Canada and USA) have participated this year.
Thank you to everyone who participated!

You can see the current summer program and news here at the Blog：http://clubkeiki.blog.fc2.com/

Furthermore, The schedule of the CPC Hawaii Spring/Summer Kids Program(Club Keiki) 2020 has been decided and applications just started!

CPC Hawaii Spring/Summer Kids Program(Club Keiki) 2020

*SPRING 2020
(March 23,2020 - March, 27,2020) 1 week

*SUMMER 2020
1st week: July 20,2020 - July 24,2020
2nd week: July 27,2020 - July 31,2020
3rd week: August 3,2020 - August 7,2020
4th week: August 10,2020 - August 14,2020
5th week: August 17,2020 - August 21,2020

Reference materials: Club Keiki 2019 Pamphlet

This is the application form for Club Keiki at Central Pacific College(CPC).
After sending in your application you may expect a reply within 3 business days. If you do not receive a reply within 3 business days, we humbly ask that you send another application form.

【Enrollment Dates】 ^*

＜You may choose any of the following weeks for the Spring and Summer 2020 program by August 23, 2019＞
1 week
2 weeks
3 weeks
4 weeks
5 weeks

＜SPRING 2020＞
(Elementary school and Junior high school students：6 to 14 years old)

3/23/2020～3/27/2020

(Elementary school and Junior high school students：6 to 14 years old)

7/20/2020～7/24/2020
7/27/2020～7/31/2020
8/3/2020～8/7/2020
8/10/2020～8/14/2020
8/17/2020～8/21/2020

【Student Information】

Name ^*

Gender ^*
MaleFemale

Date of Birth ^*

Nationality ^*

Home Address ^*

Postal Code

Phone Number ^*

Country Code

Parent's Email Address ^*

【Emergency contact】

Parent/Guardian’s Name ^*

Relationship ^*

Phone number and Email address in Hawaii
Parent/Guardian’s Name in Hawaii：

Parent/Guardian’s Phone number in Hawaii：

Parent/Guardian’s Email address in Hawaii:

【Optional】

Photos of your child's experience in the program will be taken and made available online. If you would like to buy photos of your child's experience in the program, please check "Yes, I would like to purchase photo packages of my child in the program." below. If you check yes, the photo fee matching your child's length of enrollment in the program will automatically be included in your overall tuition fee. CPC will send an online link to these photos within 2 months after the end of the program. ^*
Yes, I would like to purchase photo packages of my child in the program.No, I am not interested in buying a photo package.

Cost based on weeks enrolled
１week	$20
2weeks	$25
3weeks	$30
4weeks	$35
5weeks	$40

【Others】

Payment methods (Registration) ^*
Credit CardWire Transfer (additional $35)Personal ChecksAlready paid online

Payment methods (Tuition) ^*
CashCredit CardWire Transfer(additional $35)Personal Checks

How did you learn about CPC? ^*
Website FriendInternet/SNSBlogAgentOthers

CPC Family Package ^*
*Please submit attached application form
to info@cpchawaii.com
1 Adult + 1 Child：Homestay1 Adult + 1 Child：Condominium Residence(Shared Condo)1 Adult + 2 Children：Homestay1 Adult + 2 Children：Condominium ResidenceNone

PROMO CODE

Questions
*If your child has participated in the Club Keiki before, please mention it in the box below when you submit your question. A discount will be applied to your registration fee.
**If more than one family member will be enrolled in a program at CPC, please mention it in the box below when you submit your question. A discount will be applied to the second child's tuition fee.
***If you will be staying with a host family, please mention it in the box below when you submit your question.

Please read the refund/cancellation policy.
I have read and agree to the refund/cancellation policy. ^*
(You must check this box in order to submit your application.)

更新日：August 15, 2019