Kaua‘i Institute Registration

Please complete this questionnaire to register as an Kaua‘i Affiliate Attendee.
Registration is free for two (2) representatives from each group.
Additional representatives may join at a cost of $20 per person.

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* 1. Affiliate Group Name

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* 2. Your First Name

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* 3. Your Last Name

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* 4. Your Position with your Affiliate Group

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* 5. At what email address would you like to be contacted with additional conference information?

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* 6. Transportation (Choose One):

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* 7. Food Lunch Options (Choose One):

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