Honolulu Lodge 616 BPOE
Secure Payment Form
Member Dues Statement Summary
Regular Dues + GLSA - $400:
Life Dues + GLSA - $65:
Elks Lodge National Foundation Optional - $25:
Major Project Purple Pig - $25:
Scholarship for Hawaii Students Optional - $25:
First Parking Decal - $100::
Second Parking Decal - $150:
Men's Locker Room Entry Key Card - $90:
Women's Locker Room Entry Key Card - $90:
Pre Assigned 3ft Locker with Lock - $90:
Pre Assigned 2ft Locker with Lock - $70:
Men's Fitness Room Entry Key Card - $150:
Women's Fitness Room Entry Key Card - $150:
Pre Assigned Surf Board Rack Regular Size- $180:
Pre Assigned Surf Board Rack Large Size- $240:
Pre Assigned Canoe Rack - $300:
Initiation Fee - $1900:
Order Amount
Convenience Fee (3%)
Total Amount
Invoice Number
Customer IP
Description
Member Information
Member Number
First Name
Last Name
Phone Number
Email Address
Credit Card Information
Name as on Card
Card Billing Address
Card Billing Zip
Card Number
Card Expiration Date
CVV2/CID
