Annual Membership Dues for Single Membership

Individual Membership: $25 per year
Renewal Deadline: March 1 each year
New Year-End Memberships: Prorated
Payment Method:
- Online Payment for Family Membership
- If you prefer paying in person please opt-out. Click this link (link)
Mailing Address for Payment:
94-974 Pakela Street, Unit 104
Waipahu, HI 96797

I am signing up for Single Membership.

Yes

Primary Member Information

First Name

Last Name

Phone

Address

Street Address

City

State

Country

Postal Code

Date of birth

Preferred Method of Correspondence

Mail

Sponsor Information (Optional)

By signing the application, the applicant agrees to:

Abide by PCHC’s mission, bylaws, guidelines, objectives, rules, and regulations

Confirm they are 18 years or older

Names Only:

Yes

Email Address:

Yes

Phone Number:

Yes

Signatures of Primary Applicant | Signature/Co-Applicant Signature

Write your signature here.

94-974 Pakela St., Unit 104 Waipahu, HI 96797

A 501(C)3 NON-PROFIT ORGANIZATION FEDERAL ID NO. 82-3544651