EAA1114 : Join EAA 1114

	Monday, September 06, 2010

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Member Information and Registration Form

Chapter renewal dues are $30.00 per year and are due January 1st. For new members dues are prorated month by month throughout the year. The EAA requires that each member of a local EAA chapter be a current member of the national organization. Please include your EAA # and expiration date on this form. Chapter meetings are held the third Saturday of each month at the Cox Field Bull Shack, Apex, NC. Check www.eaa1114.org for the latest information and additional forms.

NOTE: All items below which are highlighted are required fields. Your submission will not be accepted unless these fields are included. Do not hit RETURN or ENTER until the form is complete as this will submit the form. Use TAB to move between fields, instead.

First Name

Last Name

Address

City

State

Zip

Birthdate

(mm/dd) Birth year not requested!

EAA #

EAA Expire Date

(mm/yy)

Home Phone

Work Phone

Cell Phone

E-mail Address

Occupation

Employer

Spouse

Children

Ratings

Aircraft Owned

Previous Aircraft Owned

Projects

Aviation Interests

Interested in offering your help/services in one or more of the following areas :

Monthly Programs	Building	Instructing	A/C Maintenance
Young Eagles	PreFlight	Newsletter

Other Activities

What do you hope most to gain from participating in the EAA?

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Add to Chapter Listserver

Contact Ed Savage if you have any questions about chapter membership.

Last updated: Fri Jan 8 08:37:41 2010