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.