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Lahaina Hawaiian Civic Club
Application for Membership
Reestablished September 25, 2004
Please complete this form and send a check with the appropriate dues amount to the membership committee. Checks should be made payable to Lahaina Hawaiian Civic Club.
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Inoa Piha (Full Name)
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Your answer
Inoa Male'ole (Maiden Name if applicable)
Your answer
Lā Hānau (Date of Birth)
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Age
Your answer
Address
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Your answer
Mobile Phone
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Your answer
Home Phone
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Your answer
Work Phone
Your answer
Email
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Your answer
Are you of Hawaiian Ancestry?
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Yes, (If Yes please answer next question)
No
What is your percentage?
Your answer
Have you ever applied for membership to this Chapter?
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Yes
No
If Yes, What was done concerning your application?
Your answer
Do you belong to any other Hawaiian civic club(s)? If so which one?
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Your answer
Please describe briefly why you desire to become a member of the Lahaina Hawaiian Civic Club.
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Your answer
A club is only as strong as its strongest members, and weak as its weakest members, describe briefly how you are able to contribute to the success of the LHCC.
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Your answer
I desire to become a Member of the Lahaina Hawaiian Civic Club. In place of signature please type your full name below
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Your answer
Date
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Oath Given by
Option 1
Clear selection
Signature of Parent or Legal Guardian if under 18 years of age
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Your answer
Title
Your answer
Type of Membership- Annual Dues shall be paid by February 15th of each year and any dues paying member who shall be delinquent in the payment of dues by March 1st shall be deemed to have forfeited said Membership
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Nā Lālā (Regular Membership) $25 per year
Nā Lālā Pa'a Mau (Life Member 18-59 years) $250 (Plus $5 per year)
Nā Lālā P'a Mau (Life Member 60 years and above) $100 (Plus $5 per year)
Nā Lālā Hanohano (Honorary Member) $10 per year
Nā Lālā Pua (Keiki Member 0-17 years) $5 per year
Sponsored by (Inoa)
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Endorsed by (Inoa)
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