Membership Application Form Membership Application Fields marked with an * are required First Name * Last Name * Date of Birth * Email * Phone - Home * Phone - Work Employer - Occupation * Divider FAA Certificate Number Ratings Medical (Class & Date) Medical (Restrictions, if any) Total Hours Total Night Hours Total IFR Hours Total Complex Hours Aircraft Types & Approximate Hours Biennial Flight Review (Date) Biennial Flight Review (Aircraft & CFI) Names & Addresses of Clubs/FBOs whose aircraft you have flown Types of Flying? (VFR, IFR, business, pleasure, long trips, hours/year?) Flying Plans/Objectives? How did you hear of the 150th Aero Flying Club? Divider Mandatory The following two questions must be answered! Explain if the answer to either is "Yes ". Answers will be kept strictly confidential. Have you ever been involved in an aircraft accident? * No Yes Explanation Has the FAA ever taken any action against you? * No Yes Explanation Divider Agreements By submitting this Application for Membership to the 150th Aero Flying Club, hereafter referred to as the Club, you are certifying that the above information is accurate and complete and, if offered membership in the Club, you further agree that if you are offered membership into the club, and you accept the offer:(a) you will pay a non-refundable initiation fee of $700(b) you will deposit an equal share bond in the Club for $2400, which is refundable upon resignation;(c) you will timely pay monthly dues, hourly flying charges, and any special assessments authorized by the membership or the Board of Directors;(d) you will be guided by and obey the Constitution, By-Laws, and Operating Instructions of the Club; Recaptcha If you are a human seeing this field, please leave it empty.
