Aeronca Aviators Club   Flying Windsock        Membership Application                         Click here for Online Membership Page

Please print and mail to:           U.S. International
    Aeronca Aviators Club Dues:         (incl. Canada)
    PO Box 100 1 year           $35     $40 USD
    Coxsackie NY 12051 2 years           $67     $75 USD
    3 years           $98   $114 USD

Name: ________________________________   Spouse: ________________

Address: ______________________________________________________

                _______________________________________________________

City, State: ________________________________       Zip: ______________

Tel (Home): _______________________    (Work): ______________________

E-mail Address: __________________________________________________

Comments: ______________________________________________________

                    ______________________________________________________

Do you own an aircraft?                                             I'm lucky!   I own two:

Year: ______  Model: ___________                   Year: _____   Model: __________

Registration: (N) _______________                   Registration: (N) ______________

Please make check payable to: Aeronca Aviators Club       ....Welcome to the Club....
Member Contact Information Privacy Policy: To assure your right to privacy yet fill the need for intra-Club communication, we are implementing an "opt-in" program. To be available to other members [only], please check below: I agree to allow the Aeronca Aviators Club to release the information checked below to current Club members:

Home Telephone Number (as listed above) or special number: (_____) _____________________

Work Telephone Number (as listed above) or special number: (_____) _____________________

Email Address (as listed above) or special address: ____________________________________

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