Event Sign-Up Form

 

If you prefer to register electronically please fill out the web form 

below and indicate how you plan to pay then press the Submit button.

You will then get instructions for paying on the next screen.

 

Member, Spouse:

(Separate names with commas)

Guests & Keiki:

(Separate names with commas)

 

Number of adults @ $15 ea:   Qty: Number of Keiki 12 and under-Free:  Qty:
Email:  

          Luncheon Total $

Donations Greatly Appreciated:    Scholarship & Community Services $ 
Luncheon + Donation Total: $    Do you need a ride?  

There are two ways to pay, Check or Credit Card. Indicate your payment Method:

  

By Check:  Provide any comments and press the Submit button below.  Mail your check to: Hawaii State Chapter, MOAA,  P. O. Box 31282, Honolulu, HI 96820, with a memo note on the check saying what it is for.

With a Credit Card:  Remember the total amount you are paying.   Provide any comments and press the Submit button below.  You will be taken to a page where you will make your payment.

   

Comments or Information Request:

  (Please be patient - Do not press on

  the Submit Button more than once)