New Yomitan Member Signup Form

Welcome to Yomitan Club Hawaii!

We'd like to get to know you better and find out the best way to stay connected with you. Please complete the form below.

Your Information

First Name

Last Name

Birthyear

This allows us to celebrate and honor milestone birth years and track when you can convert to the FREE Senior (65+) membership!

Your Contact Information

Preferred Phone

Home

Mobile

Both

Street

City, State, Zip

Preferred Method of Contact

When Yomitan sends out regular newsletters and other updates, would you prefer a physical or digital copy?

Physical Mail

Both

New members with all types of connections to Yomitan are welcome to join the club!

Please provide additional information about your connection to Yomitan.

Yomitan Connection

Father

Mother

Both Parents

Non-familial

Membership Details

Select Your Membership Type

Individual (over 25 years) = $15/year

Family (includes partner/spouse and dependents) = $30/year

Senior (65 years +) = Free

We will be in contact after membership submission with instruction on how to pay annual dues.

Individual

Family

Senior

Get Involved

Club Interests

Send me a copy of my responses