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MEMBERSHIP $15.00 Yearly

EAA CHAPTER _____________

MANATEE 48X

DATE:__________________                                                                PLEASE PRINT

 

 

NAME: ________________________________________________________________

 

 

ADDRESS: ____________________________________________________________

 

 

E-MAIL:___________________________________TELE: ________________________

 

 

EAA MEMBER #_____________________________EX. DATE____________________

 

 

 

PILOT:  YES [  ]   NO [  ]     PRIVATE [  ]    SPORT [  ]   U/L [  ]  OTHER _____________

 

 

PLANE ____________________________  OWN [  ]    RENT [  ]

 

WHAT SKILLS  ARE YOU  WILLING TO USE TO HELP THE CHAPTER ?

 

I CAN _______________________________________________________

 

____________________________________________________________

 

 

DO YOU LIKE HAVING CHAPTER COOK-OUTS?  :  YES [  ]   NO [  ]    

 

HOW OFTEN?  ONCE EVERY _______ MONTH

 

 

MEMBERSHIP  $ 15.00               DONATION: $ ___________      TOTAL $___________

 

 

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