EAA CHAPTER 157 MEMBERSHIP APPLICATION & RENEWAL FORM

 

Membership is $20 per year 

 

Date________________   

 

New Member_______             Renewal_____                             

 

Primary Member:                                                                  

 

Name__________________________ National EAA member?____Member #________

 

Address_____________________________________ Phone ___________________

 

City ___________________________ State____________Zip_________________

 

E-mail________________________________________________________________

 

Birthday (m/d)________________________________________

 

Spouse's Name ________________________ Anniversary?___________________

 

    

Make checks payable to EAA Chapter 157 and mail with application to:

EAA Chapter 157

P.O. Box 992353

Redding, CA. 96099-2353

 

(  ) Membership  $20 per year

 

All renewals due in January. Delinquent February 1st.

 

 

AMOUNT ENCLOSED $___________

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Officer Use Only

 

Amount Received____________Check____Cash_____

 

Signed_______________________________________