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Paniinoa

Account Information

First Name *

Last Name *

Email *

Username *

Password *

Confirm Password *

Address *

City *

State *

Country *

Postal Code *

Native Hawaiian? *

Yes

No

Are you a Hawaiian Homesteader? *

Yes

No

What is your Hawaiian name?

Age Group *

What is your home island?

Mobile phone *

Payment Information

Initial registration

$

Subsequent fees

$

Credit or Debit card