Having accurate, up-to-date information is important to your Chapter and to you. Please fill out this form and return it,along with your appropriate dues, to Jeff Orr (address below)
 

DATE:__________________________________________

CHECK ONE:
Aplication for introductory (new) membership___Renewal___Associate Membership_______

NAME:__________________________________________DOB:__________________

SPOUSE_________________________________________

MAILING ADDRESS:_____________________________________________________

CITY:_______________________________STATE______________ZIP:____________

HOME PHONE:________________BUS. PHONE;____________CELL PHONE:______________

FAX PHONE::________________________E-MAIL:_____________________________________

EAA#;_________________AOPA #________________YOUNG EAGLE #:__________________

CERTIFICATE #__________________________COMMERCIAL____PRIVATE_______________

AIRCRAFT INTERESTS: 

Homebuilt___,Production___,Antique___,Classic___,Ultralight___,Warbird___,Rotocraft___Other___

SPONSOR:_________________________________________

MEMBERSHIP:  Full membship in Chapter 59 is $24 per year, which includes the monthly publication of: 59 GRAPEVINE newsletter. Introductory memberships are available for $12 (first year only).Dues are prorated  after March of each year. The year begins in January for all members. Associate memberships are available to businessmen and those interested in getting the 59 GRAPEVINE newsletter but who cannot participate in the regular events of the year. These memberships are $24. Student-memberships are available to full-time students at $6/six months upon proof of their enrollment. Regular members are also required to join National EAA after their introductory year. Forms for joining National can be obtained from the secretary or treasurer. 

Mail or hand check for membership to:  Jeff Orr, Treasurer,  P.O. 5434, Waco, Texas, 76708. 
E-mail:  j-orr@juno.com. VERY IMPORTANT! Include this form with your payment.