NORTHWEST FLYERS Application (Printable Version)
NORTHWEST FLYERS, INC.
New Member Application
Member from whom share is intended to be acquired __________________
Prospective Member Data:
Name __________________________________
Address __________________________________
_________________________________
Phone Numbers ______________________________
Fax _______________________________
E-Mail Address ______________________________
Date of Birth _____________________________
Occupation ______________________________
Pilot Certificat(s) _______________________________
_______________________________
Pilot Rating(s) ______________________________
_______________________________
Approximate logged hours – Total/ PIC _______________________________
Brief summary of pilot experience ______________________________
__________________________________________________________________________
_________________________________________________________________________
Have you ever had your pilot license suspended or revoked? ______________________
Have you ever been convicted of operating a car, boat or aircraft under the influence of alcohol or drugs? ________________________________
I have received, reviewed, and agree to abide by the By-Law, Policies, and Procedures of Northwest Flyers, Inc.
Applicant’s Signature ________________________________________
Date ________________________________________
Attach a copy of pilot license, current medical, and logbook page showing your last flight review.