NPAC's goal is to develop a local resource directory that can be used by health professionals, families and others who are dedicated to improving the health and wellness of Maui County's residents - keiki to kupuna.

 Please complete the following survey if you are currently providing services in nutrition, physical activity or local food production. Please fill in as many fields as possible as this will assist us with adding your organization to the Maui County Resource Directory.

Please complete as many fields as possible. This will allow us to properly add your listing to our Local Resource Directory.
Please Note: This form is for Organizations, Businesses or Service Professionals who wish to be listed in our directory and provide service in Maui County. If you with to signup as an individual, supporting member of NPAC, please use the join now button to the below.Join-State-NPAC 


(*) = Input is Required

Maui County Resource Directory Submission Form
  1. Who is completing this survey?(*)
    Please type your full name.
  2. Address:(*)
    Invalid Input
  3. Address 2:
    Invalid Input
  4. City/Town:(*)
    Invalid Input
  5. State:(*)
    Invalid Input
  6. Zip Code:(*)
    Invalid Input
  7. E-mail Address:(*)
    Invalid email address.
  8. Phone Number:(*)
    Please use this format: 555-555-5555
  9. Where are your programs and services located in
    Maui County?
    Check all that apply:(*)






    Invalid Input
  10. Name of Organization, Program or Provider:(*)
    Please type your Organizations Name.
  11. Which section or sections in the Resource
    Directory would you like to be listed in?
    Check all that apply:(*)



    Invalid Input
  12. Business Address:(*)
    Please input your Business Address.
  13. Business Address 2:
    Please input your Business Address
  14. Business City:(*)
    Invalid Input
  15. Business State:(*)
    Invalid Input
  16. Business Zip Code:(*)
    Invalid Input
  17. Business E-mail Address:
    Invalid email address.
  18. Business Phone Number:(*)
    Please use this format: 555-555-5555
  19. Company Website Address:
    Invalid Input
  20. Nutrition & Wellness Activities Provided?
    Check all that apply:(*)






    Invalid Input
  21. Other Nutrition & Wellness activities provided:
    Invalid Input
  22. Physical Activities Provided?
    Check all that apply:(*)














    Invalid Input
  23. Other Physical activities provided:
    Invalid Input
  24. Local Food Production Activities Provided?
    Check all that apply:(*)





    Invalid Input
  25. Other Local Food Production activities provided:
    Invalid Input
  26. Target Population?
    Check all that apply:(*)




    Invalid Input
  27. Upload your Company Logo:
    Only Gif, Jpg, and Png files are accepted. There is a 2mb file size limit.
  28. Briefly describe program and activities, hours of operation, etc. in 50 words or less.

    (*)
    Invalid Input
  29. Human Verification:
    Invalid Input
  30.   


Pending approval, your information will be added to our Resource Directory under the chosen categories.
The completion and submission of this form acknowledges your permission to NPAC to publish the submitted
information on this, or Maui NPAC Partner sites.
Many Thanks for your interest in Maui County NPAC. Please Click Here if you would like to Contact Us.