MEMBERSHIP APPLICATION
Credit Card EncryptionCredit Card Number Will Be Encrypted
FIELDS MARKED WITH * ARE REQUIRED.

Annual membership fees (including renewals) are:
US$100.00 in the United States, US$115.00 in Canada and any other country.

1. Name as it appears on your credit card:*


2. Street Address: *


3. City, State & Zip: *


5. Telephone Number *


6a. What is your e-mail address: *


6b. Please re-enter your e-mail address: *


7. If you own an aircraft, please provide the make/model and N number:


8. Credit card expiration date (ie 0402 ): *


9. Enter VISA or MasterCard number with no spaces beween numbers:*
Credit Card Encryption