To apply for this intensive, submit the following items along with your completed registration form and payment-in-full. Please submit all items together at the time of application.
We are sorry that incomplete applications cannot be accepted.
New Students: If this is your first intensive with Rosalyn and Ken, please provide the following additional typed information with your registration, limiting your answers to 1-2 paragraphs per question.
Name for ID Tag______________________________________
Emergency Contact Name__________________________________
Emergency Contact Phone#__________________________________
$975 Regular Fee
Kama’aina Rate, $50 off.
# ______ payable to HLCC and/or
including dairy & eggs (Sorry, we cannot accommodate special diets
will arrive in time for the Welcome Luau Dinner on Sunday at 5:30PM.
Would you like to share a room? Yes No
If yes, please give your gender and age. Gender: M F Age:_____
To register for this workshop please fill out the form above and send (mail, fax or email) it along
with your payment AND color photo to:
Rama Thiruvengadam, MD PO Box 390988
Keauhou, HI 96739 OR, Fax toll-free to (866) 873-7376)Email DrRama@hawaii.rr.com
Questions? Please feel free to phone
Rama Thiruvengadam, MD at (808) 443-8949, or email DrRama@hawaii.rr.com