Please select the category(ies) that bests describes your participation with PIKO
(Select all that apply)
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PIKO Pilot Applicant
PIKO GUMSHOE participant
PIKO Pilot Awardee
Both PIKO Pilot Awardee and GUMSHOE participant
PIKO Pilot Reviewer
None of the above
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PIKO PILOT AWARDEES,
GUMSHOE PARTICIPANT OR BOTH
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Last Name
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First Name
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Email
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Degree (select all that apply)
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Other Degree
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(Example: MPH, MS, MSW, etc.)
Academic Rank
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Professor, Clinical Professor, Professor Researcher or Professor Specialist
Associate Professor, Associate Clinical Professor, Associate Researcher or Associate Specialist
Assistant Professor, Assistant Clinical Professor, Assistant Researcher or Assistant Specialist
Adjunct, Affiliate
Other
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Assistant Professor
Associate Professor
Professor
Other Status
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Date of Hire (Month & Year)
If not applicable, please enter, "N/A"
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Month & Year
Tenure Status
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Tenured
Tenure track, but not yet tenured
Not tenure track
Year of Tenure
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Example: 2000
Contact number:
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Please include area code, i.e. 808-xxx-xxxx. Hit tab after entering phone number.
RACE/ETHNICITY
What race/ethnicity do you identify yourself to be? (Select all that apply)
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Specify Asian
(select one)
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Japanese
Chinese
Korean
Other Asian (please specify _____________)
More than one (please specify
Specify Other Asian
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Specify More than One Asian
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Specify Other Race
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Specify Other Pacific Islander
(select one)
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Samoan
Tongan
Fijian
CHamoru
Chuukese
Kosraean
Marshallese
Palauan
Pohnpeian
Yapese
i-Kiribati
Other PIs (please specify __________)
More than one (please specify __________)
Specify Other Pacific Islander(s)
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Specify More than One Pacific Islander
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Select your Campus
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University of Hawaii at Manoa
University of Hawaii at Hilo
University of Hawaii Maui College
University of Hawaii West Oahu
Other
Specify Community-Based Organization
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Specify Practice-Based Organization
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Specify Other
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Please select primary school/college
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College of Arts and Humanities
College of Education
College of Engineering
College of Languages, Linguistics and Literature
College of Natural Sciences
College of Social Sciences
College of Tropical Agriculture & Human Resources (CTAHR)
Colleges of Arts & Sciences
Hawai'inuiakea School of Hawaiian Knowledge
John A. Burns School of Medicine (JABSOM)
Nancy Atmosphera Walch School of Nusing and Dental Hygiene (NAWSoN)
School of Architecture
School of Ocean & Earth Science & Technology (SOEST)
School of Pacific & Asian Studies
Shidler College of Business
Thompson School of Social Work & Public Health
UH Cancer Center
William S. Richardson School of Law
Other
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Business
Travel Industry Management
Select one of the following
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Social Work
Public Health
Center of Aging
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If your study is under JABSOM Department(s), select all that apply
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Name Other JABSOM Dept/Office/Program
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Please select primary school
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School of Natural Sciences and Mathematics
School of Business and Communication
School of Education and Behavioral Sciences
School of Humanities, Arts and Design
School of Nursing and Health Professions
Please select primary college
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College of Business
College of Health and Society
College of Liberal Arts
College of Natural and Computational Sciences
College of Professional Studies
Thank you for using the PIKO Core Services. Kindly acknowledge PIKO in all future publications and presentations with the PIKO Grant Award U54GM138062 .
You will now be directed to the Request for Core Support form to put in your request.
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