United Jr. YBA of Honolulu Membership Form

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<bit.ly/jrybahawaiiapplication> Must be completed by prospective and continuing Jr. YBA members (6th Grade - 2 years post High School Graduation) and advisors.

After you fill out this form, please send your $20 dues to Treasurer Dojun Baba (1727 Pali Hwy, Honolulu Hawaii 96813). (Jr. YBA members only)

Membership Type? *

Renewal of Membership

New Member

Advisor

LAST Name *

FIRST Name *

Email Address *

Cell Phone *

Mailing Address (City, State, Zip) *

What gender do you identify as? *

Female

Male

Non-Binary

Prefer not to say

Other:

Birthdate (Jr YBA members only) *

YYYY

Grade *

School *

Temple Unit *

Honpa Hongwanji Hawaii Betsuin

Jikoen Hongwanji

Moiliili Hongwanji

Windward Buddhist Temple

Not affiliated with a temple

Other:

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