Northwest Flyers Application

NORTHWEST FLYERS Application  (Printable Version)


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.

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