Basic Orientation Workshop (Bow) Registration Form

THE JUDICIARY -- STATE OF HAWAI#I

NTERNAL

Date Rec'd:

OFFICE ON EQUALITY AND ACCESS TO THE COURTS

2017 BASIC ORIENTATION WORKSHOP (BOW)

REGISTRATION FORM

INSTRUCTIONS:

Completed registration form and $95 fee must be RECEIVED by 4:00 p.m. on Wednesday, May 31, 2017.

MAKE CHECK OR MONEY ORDER PAYABLE TO: State Director of Finance.

Submit check or money order (cash not accepted) and SIGNED registration form to:

Office on Equality and Access to the Courts, 426 Queen St., Rm. B17, Honolulu, HI 96813 .

Please TYPE or PRINT CLEARLY in blue or black ink. Information on the form must be complete.

REGISTRATION INFORMATION

PLEASE STATE THE NON-ENGLISH LANGUAGE(S) / DIALECT(S) YOU INTERPRET IN:

Salutation

Work Phone

Home Phone

Cell Phone

❑ Mr.

❑ Mrs.

❑ Ms.

First Name

Middle Name

Last Name

Mailing Address

City, State, Zip Code

Email Address

BOW REGISTRATION DEADLINE: MAY 31, 2017, by 4:00 p.m.

Registrants must attend BOTH DAYS of the BOW. Seating is limited in each location. Register early to guarantee

acceptance of your registration. A Registration Acceptance Notice will be sent confirming your registration date/time

and session location.

June 15 - 16, 2017

8:30 a.m. to 4:30 p.m.

HAWAI‘I - HILO

Registration starts at 8:00 a.m.

Hilo Courthouse

(Thu. & Fri.)

I understand that the Office on Equality and Access to the Courts (OEAC) will send a Registration Acceptance

Notice to confirm my registration for the BOW. Should it become necessary for me to cancel my confirmed

registration, I agree to promptly notify OEAC by calling (808) 539-4860 or emailing oeac@courts.hawaii.gov.

I understand that I will receive a refund of the registration fee, less a $20 administrative processing fee, only if I

notify OEAC prior to the cancellation deadline specified in the Registration Acceptance Notice. If I cancel after the

cancellation deadline, I understand that no refund will be issued. OEAC reserves the right to cancel any session

due to insufficient registration, with notice to registrants and full refund of registration fee.

Signature:_______________________________________________________

Date: ____________________

Please specify any special accommodation(s) needed to participate in the BOW due to the Americans with Disabilities Act

(ADA):

Hawai‘i State Judiciary, Office on Equality and Access to the Courts,

(rev. 5/9/17)

Basic Orientation Workshop (Bow) Registration Form - 2017 Page 2

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