Hawaii Transportation Association - Driving Hawaii’s Economy
Safety Compliance Materials
Safety Class Registration
Credit Card Authorization Form
Thank you for Registering. Please fill out the form below if you would like to have us charge you via credit card authorization.
Name of Cardholder (as it appears on the card)
Billing Address of Cardholder
What is this payment for? Please note the class, event, etc you are paying for.
Amount of transaction authorized $
Credit Card Number
3/4 digit pin (back of card)
Signature (Writing out your full name below authorizes and agrees to the amount on this transaction)
If you are human, leave this field blank.
Hawaii Transportation Association
P.O. Box. 30166
Honolulu. Hawaii 96820
Phone: (808) 833-6628
Fax: (808) 833-8486
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