User Registration Form

Join the Malama Hawai'i On-line Information Network! Through the network we can provide you with timely information you can use and, in turn, you can tell us more about you and the issues facing Hawai'i you care most about.

Please fill out the information in each section. Your responses will help us better understand this community that wants to make Hawai'i a better place to live. We will be using the information you provide us in tandem with market research to help guide our projects and public awareness activities. Your personal information will not be shared with any outside group. Your responses will help us shape Malama Hawai'i into the group you want it to be. Thank you for your help. You will receive a confirmation message from us shortly.

Please check this box if you are over 13 years old:

YOUR INTERESTS

1. Are you a Hawai'i resident?   Yes   No

2. Are you interested in volunteering with our member organizations to help make Hawai'i a better place?
Yes   No

3. Which of the following issues interest you? (select all that apply)

I'm interested in all of these
 
Upcoming Events
Volunteer Opportunities
Education Opportunities
Latest News
Hawaiian Plants and Animals
Hawaiian Ocean/marine life
Coral Reefs
Hawaiian Forests/Watershed
Island Geology/Geography
Hawaiian Culture
Polynesian Voyaging/Canoes
Parks and Outdoor Recreation
Teacher Curricula
Historic and Cultural Preservation
Health and Wellness
Community-friendly Companies
Job/Intern Opportunities
Teacher Training Opportunities
Grants/Funding Opportunities
Legislation/Public Hearings
Fundraisers
Invasive Species
Freshwater/Streams
Youth Outreach Activites
Culture and Arts
Recycling/Waste Disposal

4. If you're interested in any other topics not listed here, please tell us what they are:

5. Would you like to join our mailing list to receive email about the issues you've indicated above?
Yes   No

ABOUT YOU

6. Name (required):

7. Email address (required):

8. Age:

9. Your zip code:

10. Gender:   Male   Female

11. Do you have children?   Yes   No

12. If you have children, how many are school aged?

13. Ethnic background (select the one you most closely relate to): Select African American American Indian Caucasian Chinese Filipino Hawaiian Japanese Korean Latin/Hispanic Mixed ("Hapa") Pacific Islander Vietnamese Other

14. If 'Other,' please list your ethnic background here:

15. Education (highest level completed): Select Not yet in High School Still in High School High School Graduate/GED Vocational Training/Apprenticeship Attended/Attending College College Graduate Attended/Attending Graduate School Graduate School Degree Post-Graduate Degree

16. If you are a Hawai'i resident, were you born here?   Yes   No

17. If you are a non-native Hawai'i resident, what year did you arrive?

18. How did you find out about our website? Select Radio Television Newspaper A friend Online search Other

19. If 'Other,' please tell us how you discovered Malama Hawaii:

THANK YOU

Thank you for taking the time to answer the questions in our survey. All responses are kept strictly confidential. Please visit our website again periodically to participate in future online surveys.