Student Request for Information

Tell us about yourself

First Name

Last Name:

Middle Name

Current Mailing Address

City

State

Zip Code:

Country

Email Address:

Phone Number:

Please include Area Code

Birth Date

(mm/dd/yyyy)

Current School Name

High School or College

I would like a UH Hilo brochure to be mailed to me.

YesNo

What are your plans at UH Hilo

When are you planning on attending UH Hilo?

I am plan to enter as a

Entering Term

Entering Year

Intended Major

I have:

Not yet applied to UH HiloApplied to UH Hilo but have not yet heard backApplied to UH Hilo and have been accepted!Other

Other: