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TWIN STATE FLYERS MEMBERSHIP APPLICATION

Please fill out and SUBMIT, or print and mail to: Twin State Flyers, PO Box 5530, Lebanon, NH 03784. Dues are $24/year, prorated for new members at $2/month. Dues may also be mailed, or brought to a Chapter meeting. All Chapter members are required to be members of EAA. For further information, contact Dino Vlahakis at: 603-448-3729, or any Chapter officer.

Personal Information:
Name: Date:
Addr:
City: State: Zipcode:
Home Phone: () - Work Phone: () - Ext: Cell Phone: () -
FAX: () - E-mail: EAA Number:

Aircraft/License Information:
Do you have a pilot's license? Yes: No: Certificate type:
Do you own an aircraft? Yes: No: If so, where is it based?
If factory built, Year: Make: Model:
If kit/home built, Make: Model:
Completion Date (or estimated completion date): Year:

Plans for future projects?

Areas of aviation expertise or interest?

What can TSF do to serve your needs as an aviation enthusiest?

Remarks: