EAA Chapter 182 - Memphis, Tennessee

Member Application

Want To Become a Member of EAA Chapter 182 in Memphis, TN?

Print out this page and fill in the requested information. Give this form and your annual dues to Frank Civera at the next meeting (click on chapter events on the previous page to find out when and where) or send an e-mail to frank@bits-pos.com for a mailing address. You will become a member of the Memphis Chapter (not the International Organization) when the annual dues of $25 (individual) or $35 (family members living in the same household) is received.

EAA Chapter 182

Membership, Renewal and Information Update Form

Date		Single ($25.00
Name		Family ($35.00)
Address
City State Zip
Phone e-mail Address _________________________
EAA Number * Needed for valid chapter membership

What is your interest in aviation? (Check all that apply)
Homebuilding ¡	Vintage ¡
Ultralights ¡	Racing ¡
Factory Builts ¡	Flying Professionally ¡
Aerobatics ¡	Grass Roots Aviation ¡
Warbirds ¡	Other

Tell us about your aviation background


Aircraft Owner? What Type?
Building/Restoring Aircraft?

Pilots licenses, ratings and experience


Chapter 182 runs on your energy and creativity. What areas of interest or projects are you interested in working on?



Things we’re doing right /need improvement: ________________________________________



Make checks payable to: EAA Chapter 182