EAA Chapter 234 Membership Information

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Please fill out this form to renew or request membership. If you are renewing your membership, please take the time to make sure we have your most current information submitting anything that may have changed.

After you complete this form, you will be presented with the link to follow to pay dues. Please pay $25 to complete your new membership or renewal.

Email address *

First Name *

Last Name *

Nick Name

Additional Family Members to be included in this membership (Spouses & Children)

If you are an EAA Member, please enter your EAA Membership Number (This is very helpful for us to maintain current information)

Address 1

Address 2

City

State

Zip

Birth Date

YYYY

Home Phone

Cell Phone

License / Ratings / Skills

Aircraft Owned

Aircraft Built

Chapter Participation (This chapter thrives because of member volunteers!)

Aircraft Build Committee or Build Activities

Education Committee or Youth Events volunteer

Webpage, newsletter Support

Flight Simulator support or mentoring

Pancake Breakfast participation (A major fund raiser for our scholarship fund)

IMC Club Participation (Scenario based refresher training)

VMC Club Participation (Scenario based refresher training)

Airshow Displays and public outreach events

Other:

Young Eagles

Pilot

Volunteer

Young Eagles Club Host

Young Eagles Pilot Training Mentor

Final step: Submit payment

After clicking submit to finish this form, please follow the link on the next page to submit your $25 annual membership fee. When you do, please enter your name and indicate the payment is for "Membership Dues" in the optional "What is this donation for?" box.

Thank you!

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