Chapter 304, Experimental Aircraft Association, Jackson, MI

 

 

 

 

 

 

3600 Wildwood Ave, Jackson, MI 49202 - Airport ID: KJXN

Membership Form

If you prefer to print out the form and write in your responses, please click here.  Otherwise, please answer the questions below, continue to the bottom of the page, click on the "submit" button, then bring or mail your check to the above address.  Make checks payable to "Jackson Chapter 304, EAA".

 

Date:

Select one:  New Member    Renewal    Change of Information

Last Name:      First Name:  

Street Address:  

City:       State:   Zip:  

Home phone: () - Cell phone: () -

Work phone: () - extension

E-mail Address:  

Birth Date:  

EAA (National) Member Number:    Expiration Date:

Newsletter: To reduce resources, members are asked to read the monthly newsletter on our website. If you need to receive the newsletter by US Mail, please check the appropriate box:

    Will read on-line     Send via US Mail

Roster Directory: May we include your name in the Chapter's directory, which will be made available to our membership at large and on our chapter website? Directory information may include any information you have included on this form.

    Yes, include my information.     No, I don't want anyone to know who I am.

If you are a pilot, do you currently fly?    Yes      No    Not a pilot

What certificates & ratings do you hold (i.e. Private, SEL, Instrument)?

        What do you fly now or have you flown in the past?

         

Do you own an aircraft?  Yes    No

            If yes, what type?

            

            N#:  

Do you rent aircraft?  Yes    No

            If yes, what and where?

            

  Would you recommend this rental arrangement to others?  Yes     No

Are you an FAA Certificated Mechanic (A&P)?   Yes      No

Are you building/rebuilding, or have you built/rebuilt, an aircraft?  Yes     No

If yes, what type?

How far along are you?

What else would you like us to know about you?

What kinds of activities, projects, or events would you like to see our chapter do? If we did them, would you participate?