I Belong Signup

Fill in the form below to signup to be a regular "I Belong Donor" and member of the Aloha Pride Center by having your credit card debited on a monthly basis. When you hit the "Submit" button an email will be sent to the APC to process your membership. Within 72 hours you will receive a confirmation email. The Aloha Pride Center is a nonprofit (501)(c)(3) organization and all donations are tax deductible. Note: Your address and phone number are not required information unless you would like to furnish them. -mahalo

Your Name as it appears on your credit card: *

Your Email for Confirmation: *

Subject: *

Billing Address (Street, City, State, Zip Code):

Phone Number with Area Code First i.e. (808) 555-1212:

Monthly Donation Amount: *

Credit Card Type: *

Credit Card Number: *

Expiration Date (mm/yyyyy): *

Debit credit card on 1st or 15th of month?: *

Duration desired for I Belong membership: *

May we acknowledge you as an I Belong Member: *

Any additional comments or instructions:

-Mahalo nui loa for your generosity and continuing support of your GLBTIQ community center

Aloha Pride Center

Serving the Queer (LGBTQIA) Ohana of Hawaii since 1973