Honolulu Police Department Retirees & Ohana Reunion Registration

Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Number of Requested Seats (Tables of 8)
If you selected one seat, please re-enter your name. If you have more than one requested seat, please list the last and first name (i.e. SMITH, Jane) of all projected attendees:
Method of Payment ($75/person)
HLEFCU Account Number (if paying from account)
Account Type
Card Information

If paying with credit/debit card (Mastercard or Visa only). A Credit Union representative will contact you to verify your purchase.
Card Number
Name on Card
Expiration Date
CVV/Security Code
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Additional Comments