registration

B.P.O. Elks Members Only Registration Form

The designated fields are required in order to submit your registration.

About You

First Name:

Middle Initial:

Last Name: Please do NOT include titles such as PER as part of your last name. Your current and past titles can be included in the "Elks Titles" field.

Elk Titles: Use this optional field to include your current and past titles within the Order. These will be displayed within in your User Profile.

Interests: This optional field can be used to list any special interests you have, either within the Order or outside the order. Anything you include here will be visible to other members through your Member Profile.

Show in Directory: Say yes to this field to make your city of residence, email address and special interests avaiable to other members through your Member Profile. Note that your name and lodge number (but not your email address) will be available to other registered members even if you say no to inclusion in the directory of members.

Your Account

Lodge Number:

Membership Number:

Desired username: Please make up a user name for yourself that is easy to remember and easy to type. You'll be required to supply your user name and a password each time you sign-on to Elks.org.

Password: Passwords must be 8 characters long. Passwords must contain a mixture of UPPERCASE [A-Z] and lowercase [a-z] characters as well as 1 number [0-9].

Password Strength:

Confirm Password:

Email Address: Secretaries: Please register with your own email address, not the lodge email address. Using your own address will prevent many common problems when it comes time for your lodge to appoint a new secretary.

Confirm Email: To avoid typos, please re-type your email address exactly as it appears above.

Home Phone:

Work Phone:

Security Question

Security Question:

Security Question Answer:

By registering, you are agreeing to the Terms of Service.