Student Information Form

*If you are applying for the Spring/Summer Kids Program "Club Keiki", please use this link.


Postal Code

Country Code

【Emergency Contact】

【Hawaii Address & Phone (If known) 】


(for Non F-1 Applicants)

※If you don't know the program start date, please refer to this page.


*Orientation sessions and placement tests will be offered at 1:30PM on your first day(Monday).You cannot attend classes on this day.


Please write your final date of attendance at that school:

If yes, please fill out the following
Name of Agent:

Please refer to this page. for more information regarding eligibility for an I-20.

If Yes,

I have read and understood that this is a pre-enrollment application, that I must request a refund if I cancel my enrollment(and that certain fees are non-refundable, as noted), and that my enrollment will not be completed until I obtain a visa (if required) and submit an enrollment agreement in person at CPC.
Prior to submitting my payment, I have read and understand the refund/cancellation policy*


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