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This site is not intended as a crisis or hotline web site. Local crisis
hotline numbers can be found in the front of your NATIONAL SUICIDE PREVENTION HOTLINE 1 800 273 TALK OR 1 800 273 8255
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Breaking the Silence... WALK 2003 Breaking the Silence Walk 2006 Donations/Donor Campaign
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Coming Soon! Sunday, October 30, 2005, Kapi'olani Park starting at 7:30am. In Support of Suicide Prevention Awareness "Breaking the Silence...Walk" and Family Health Fair!
REGISTRATION FORM Personal Information Registration Fee: $25.00 Sponsorship Pledges $250.00 First Name: ___________________________ MI: ____ Last Name: _____________________ Address: ______________________________________ Apt./Rm./Suite #: ________________ City: ___________________________________ State: ______________________ Zip: _____ Email: _________________________________________________________________________ Home Phone: _________________________________ Day Ph. Contact: __________________ Cellular Ph.: ___________________________ Fax: ____________________________________ Company: _________________________________________ Business Ph.: ________________ Alternate Address: ______________________________ City: _______ State: ____ Zip:___ Gender: __Female __Male Birthdate: __ __/ __ __/ __ __ __ __ T-Shirt Size:: Please circle one: xs small med. large xlarge xxlarge Print Name: _____________________________ Signature: _________________________ Date___ Mail to: Hawai'i S.P.E.A.R. Foundation of America, 2630 Maunawai Place Unit C, Honolulu, HI 96826 Check made payable to: Hawai'i SPEAR |
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*Hawai'i S.P.E.A.R. Contact # (808) 271-8582 2630 Maunawai Place, Unit C, Honolulu, Hawai'i 96826
Send mail to hawaiispear@aol.com with questions or
comments about this web site.
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