University of Hawaii at Manoa · International Programs of Outreach College Step 1 -> Step 2 -> Step 3 -> Step 4
N.I.C.E. Program Application Form

Please fill in the following information completely and clearly. (*) - required field

Please be sure you have a printer available prior to filling out this form.
If paying by credit card, you need a printer to print out the receipt.
If paying by check/wire transfer, you need to print out the final page.

1. Payment Method
* Select Payment:

2. Study Plans
Click here to view 10 Week Program Fees   Click here to view 3 Week Program Fees
* Select Program:

3. Registrant Information
* First Name (Given) Middle Name * Last Name (Family)

* Gender:
* Permanent Mailing Address (in home country)

* City State/Province Postal Code

* Birth Date:
* Country Month Day Year

* Current Telephone Fax Number * Email Address

* Do you know your Hawaii address yet?

4. Other Information
* Country of Birth * Country of Citizenship

Graduation Date:
Month Year
* Highest Education Name of School