New Yomitan Member Signup Form

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

Email*

Preferred Phone*

Home

Mobile

Both

Home Phone*

Phone

Mobile Phone*

Phone

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?

Email

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

Who are your parents?*

What generation are you?*

Select or enter value

Describe your connection to Yomitan*

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

Additional Family Membership Information

Additional Senior Membership Information

Additional Member Info

Get Involved

Club Interests

Select or enter value

Send me a copy of my responses

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