EAA Chapter 1300

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Southern Nevada EAA Chapter 1300

3500 Executive Terminal Drive

Suite 285

Henderson, NV 89052

Date:		EAA Membership #:
Name:
Family Member's Name:
Address:
City:		State:	Zip:
Phone:		Cell:
Email:
Family Member's Email:
New Member Registration Membership Renewal

Aviation Interests:
Experimental	Ultralights		Formation Flying
Restoration	Powered Parachutes		Air Racing
Antiques	Fly-Ins		Sky Diving
Air Shows	Classics		Hang Gliding
Aerobatics	Warbirds		Sailplanes
Young Eagles	Light Sport		Fly-Outs
Other:

Aircraft:
Own:		Fly:
Building:		Interested In:

I / We would be interested in serving:
as a Chapter Officer		on the Board of Directors

I / We would be interested in serving on the following committees:
Budget & Finance	Builder's Support		Nomination
Safety	Scholarships		Social
Welcome	Young Eagles		Other:

Membership Type:
Full Year ($20.00) Life ($500.00) None ($0.00)
Name Badge ($10.00)
Family Member ($10.00)

I / We agree to uphold the bylaws of Southern Nevada EAA Chapter 1300 and to promote Sport Aviation and Flight Safety in the greater Las Vegas area.
Signed:			Date:
Signed:			Date:

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