Hawaii Department of Land and Natural Resources

New Customer

Please create an account to use our system. Please note: Emergency contact information is not being saved upon entry when you create your account. Please complete your account creation and then click 'Your Account' in the upper right hand navigation. Then re-enter the emergency contact information, click 'Add contact', and 'Save changes'. This will store the information, and you can proceed with your permit request.

General Information

First Name *

Middle Initial

Last Name *

Birth Date (mm/dd/yyyy) *

Personal Information

Email Address *

Confirm Email Address *

Phone *

Search for Your Address

When autocomplete results are available use up and down arrows to review and enter to select.

Residential Address (Line 1) *

Residential Address (Line 2)

City *

State*

Postal Code/Zip*

Country *

Add Emergency Contacts

First Name

Last Name

Primary Phone (XXX-XXX-XXXX)

Secondary Phone (XXX-XXX-XXXX)

Add Contact

Senior Center Membership Request

(*)

Select Preferred Center :

Eligibility:

To qualify for membership at Neighborhood & Community Services (NCS) Senior Centers, a participant must be 50 years of age or older and

with or without a reasonable modification be:

• Able to orient correctly to person, place and time
• Able to independently navigate to programs and through center facilities safely
• Able to get on and off a county vehicle safely
• Able to remain seated in a county vehicle with the seat belt fastened until the vehicle comes to a complete stop
• Able to receive and follow instructions independently
• Able to recognize and respond appropriately to emergency warnings
• Able to adhere to the Senior Center’s Terms of Membership/Code of Conduct when participating in programs, taking advantage of services or otherwise using the facilities
• Able to maintain personal care (eating, restroom usage, personal hygiene, medication management) independently

I have read, and understand the

Eligibility of Membership.

If I no longer meet one or more of the Eligibility Requirements, an evaluation by trained staff will be utilized to determine my functional level and appropriateness of my continued participation. NCS will assist and refer prospective and current members to appropriate resources and transition them to other supportive services in their best interest and safety.

Password Settings

Password *

Maximum Characters Remaining 15

Confirm Password *

I agree to receive emails and/or notifications from Hawaii DLNR, including the Outdoors Newsletter, opportunities for providing feedback and other updates.

When you are done entering the required information, click the Create Account button below. Please note: Emergency contact information is not being saved upon entry when you create your account. Please complete your account creation and then click 'Your Account' in the upper right hand navigation. Then re-enter the emergency contact information, click 'Add contact', and 'Save changes'. This will store the information, and you can proceed with your permit request.

Create Account

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Create Notification

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