The American Studies Forum
Forum Registration Form

1) Online Registration

Please fill out this form and click the submit button for online registration and credit card information transmittal (optional) through a secure server or

2) Registration by Mail or Fax

Please fill out, print, and return this form along with payment to

The Center for Asia-Pacific Exchange
P.O. Box 23397
Honolulu, Hawaii 96823-3397, U.S.A.

or  Fax to 808-941-9575 along with payment information.


3) Payment Information

Funds may be paid to CAPE in U.S. Dollars by any of the following methods: cashier's check, international money order, international postal money order, wire transfer, or credit card. For information on payment by wire transfer, please contact CAPE.

The completed registration form and the $400.00 tuition & registration fee should be sent to the Center no later than June 20, 2011. For more information on Tuition/Registration fees for participants, click here. Tuition will be fully refundable if cancelled before July 1, 2011.

For information and assistance, please do not hesitate to contact the Center. (Tel 808-942-8553)
 
  REGISTRATION FORM
  Personal Information (Required fields are marked by *)
   Prefix:
 Mr. Mrs. Ms. Miss Dr.
   Gender:
 Male
Female
   Name (Last, First, Middle)*:
   Email*:
   Home Address*:
   Home Phone Number:
   (Please include area code
   and country code.)
   Status*:
CAPE Alumni   
Other (first time participant)
   Program Year (Alumni ONLY):
   Program Name (Alumni ONLY):
   Present Position &
   Business Address:
   Business Phone Number:
   (Please include area code
   and country code.)
   Send Correspondence to:
Home Address
Business Address
  Hotel Reservation
   Check-in Date:
MM/DD/YY
   Check-out Date:
MM/DD/YY
   Pagoda Hotel
   (per person per night):
Double Occupancy ($51.00)
Single Occupancy ($102.00)
   I/We will make individual arrangements other than Pagoda.
   Name of Hotel:
  Payment Method
  Payment will be made by:
  For Credit Card Payments Only: (Secure Server)
   Type of Card:
 Visa Master Card JCB
   Cardholder Name:
   Card Number:
   Card Expiration Date:
Month    Year
   Please state amount to be
   billed to your card*
$   (example:  400.00)

*The total amount should include the tuition & registration fees. Hotel charges may be paid after your arrival in Honolulu.

I authorize The Center for Asia-Pacific Exchange to process my payment as indicated in the "amount to be billed" space provided above, through the credit card information I have provided on this registration form. I certify that I am at least 18 years of age.
 Remarks (optional) - Comments?
Note: Before sending your registration form, please make sure that all information are entered correctly. If you are ready, click on the submit button now.

Reminder: You may also choose to print out the completed form and mail or fax your registration to us at: The Center for Asia-Pacific Exchange, P.O. Box 23397, Honolulu, HI 96823, U.S.A.. Fax: (808) 941-9575)