Please accept my application for membership in the Maine Powerchute Association. I am providing the following information for application purposes only.
I understand current membership dues are $20.00 annually.
Name:________________________________________________________
Address:______________________________________________________
City/State/Zip:__________________________________________________
Home Phone:___________________________________________________
E-mail:________________________________________
Work Phone: ___________________________________________________
Affiliation In membership (ASC, EAA, USUA, etc):_____________________
FAA Rating (Sport Pilot, Private, commercial, etc):______________________________
Years flying PPC:_______________________________________________
Total years flying (all aircraft):______________________________________
Total flight hours (all aircraft):_______________________________________
PPC type(s) owned:______________________________________________
Enclose $20.00 annual dues. $30. for family membership. You'll be notified of all upcoming meetings and events.
Please fill in all sections and return to
Bonnie Davis Micue
PO Box 13
Warren ME 04864-0013
(Items in RED must be filled out - all others are optional)
Maine Powerchute Association