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English N Pua Ha`aheo o Manokalanip (The proud children of Manokalanip) Name: Address School My name for the new

Pup: Explanation of Name: Birth Date

Applicant signature Parent or Guardian name: Parent or Guardian Signature: Describe any assistance provided by adults:

(You may include an attached drawing or illustration on the back if you desire.)

lelo Hawaii N Pua Ha`aheo o Manokalanip (The proud children of Manokalanip) Kou Inoa Kou Wahi Noho Kou Kula Kou inoa no ka sila pepe: E wehewehe I ke kaona o kia inoa : Kou L Hnau

Applicant signature Parent or Guardian name: Parent or Guardian Signature: E haI I ke ano kkua mai n mkua:

(Ina ua makemake, hiki ke hoopili I kekahi kahakii)

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