EAA Chapter 879
New Member Interest & Event Registration Form
Personal Information
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone:
Email:
EAA Information
EAA #:
Join Date:
Would you like to add Family Members (Spouse, Son/Daughter, Legal Dependent)?
Yes
No
Family Member Names:
Spouse:
Son/Daughter:
Other Legal Dependent:
Aviation Information
Please identify as:
Aviation Enthusiast
Pilot
Pilot Details
Ratings (e.g., PPL, IFR, CPL):
Aircraft Owned:
Aircraft Built:
Chapter Interests
Interests (e.g., Volunteering, Young Eagles, Building, etc.):
Event Registration
Please select events you'd like to register for:
Monthly Chapter Meetings
Young Eagles Flights & Rallys
Chapter Fly-Outs
Aircraft Building and Mods
