B47HA MEMBERSHIP APPLICATION

 

  • PLEASE PRINT, & COMPLETE ALL ITEMS IF APPLICABLE, ENCLOSE CHECK, AND MAIL TO: BELL 47 HELICOPTER ASSOCIATION INC. 28931 BRINK RD. SHATTUC, IL. 62231
  • IMPORTANT NOTICE: NEW MEMBERSHIPS ARE $125.00usd. ┬áRENEWALS ARE $30 PER YEAR. IF A MEMBER EXCEEDS A 4 YEARS LAPSE IN THEIR MEMBERSHIP THEY MUST REJOIN WITH THE NORMAL $125.00 GIFT LEVEL.
  • YOUR CHECK #___________OR CASH________ YOU MAY ALSO USE A CREDIT CARD AT OUR WEBSTORE PAGE.
  • NEW INDIVIDUAL $125___GOLD WITH FRAME $1000______GOLD W/O FRAME $750________RENEWAL $30______
  • DATE_________________CURRENT ROSTER MEMBERSHIP #______________
  • YOU MAY CHECK ROSTER AT http://bell47helicopterassociation.org/site/roster/
  • NAME_________________________________________________________________________________________________ADDRESS______________________________________________________________________________________________CITY_____________________________________________________STATE___________________ZIP_____________________COUNTRY______________
  • PHONE OFFICE__________________________________CELL______________________________HOME___________________
  • E-MAIL___________________________________________________
  • HELICOPTER MODELS OWNED OR RENTED REGISTRATION NUMBER: ______________________________________
  • BELL 47 PILOT FLIGHT HOURS__________________________________________
  • PILOT OR MECHANIC RATING/S_____________________________________
  • PROXY OPTION: I HEREBY PROXY MY VOTE TO PRESIDENT JOEY RHODES. (PLEASE SIGN & DATE)___________________________________