The Wings Club | Membership Details | Membership Application

For a printable version of this application, CLICK HERE

*If you prefer to fill out the online application, the original must be faxed or mailed with a signature and credit card number with expiration date.

Name:

Date:

Position/Title:

*Your Email Address:

Company:

Business Address:

Home Address:

City:

State:

Zip

Zip:

Business Telephone:

Home Telephone:

Business Fax:

Home Fax:

Is your company/organization listed in the World Aviation Directory?

Yes No

Please send mail to my:

Home Address Business Address

My roster listing is my:

Home Address Business Address

Date of Birth:

Place of Birth:

Country of Citizenship:

Spouse Name:

Piloting Experience:

Spouse Privilege Card:

Yes No

(No additional charge. Spouse will have his/her own card with same account number. Charges incurred will appear on the same invoice.)

Membership in other Clubs, Military and/or civil associates:

Proposed by:

Seconded by:

How did you hear of the Wings Club?:

Occupation Code:

Credit Card:

Visa Mastercard AmericanExpress

Credit Card Number:

Expiration Date:

Mandatory to process application. Should my membership be approved, please charge my credit card.
Yes No

Please do not send any fees until notified of acceptance.