Name:
Spouse Name:
Partner's Name:
Street:
City:
State: Zip:
Home Phone: Work Phone:
E-mail:
Occupation/Special Skills:
Type Aircraft Owned: Engine HP:
Registration No: Serial No:
I hereby submit this application for membership in the Short Wing Piper Club. I have enclosed a check or money order payable in U.S. currency for the following:

Check all desired
Individual Membership: 1 year 2 years 3 years
U.S. / Canadian $40.00 USD per year
Foreign $50.00 USD per year
Spousal Membership $7.00 USD per year
Partner Membership $7.00 USD per year
Library Donation: $ Education Foundation Donation: $
TOTAL: $
Note: Spousal and partner memberships will not receive the Short Wing Piper News but otherwise will have full membership privileges, including telephone and mail access to the club library, tools and database plus voting privileges at the business meeting at the annual convention
SIGNATURE: ________________________________________________
DATE: ___________________________________

 


Checks or money orders payable in U.S. currency should be made out and mailed to

Short Wing Piper Club, Inc.
PO Box 10822
Springfield, MO 65808-0822