Membership Application

KEMPSEY FLYING CLUB Inc

ADDRESS: Airport Rd, ALDERVILLA 2440
POSTAL ADDRESS: PO Box 197, KEMPSEY 2440
EMAIL ADDRESS: info @kempseyflyingclub.com.au

FULL NAME

ADDRESS

POSTAL ADDRESS (If Applicable)

TELEPHONE

Email

Confirm

FLYING MEMBER ONLY TO COMPLETE
(Social Members Need Not Complete The Next Section)

Licence Type

Medcial Certificate Expiry Date

Biennial Flight Review Expiry Date

I agree to be bound by the Laws and Rules of the club

Comments

FLYING MEMBERS: $55.00
SOCIAL MEMBERS $22.00
BANK DETAILS: Coastline Credit Union
BSB: 704 189
ACCOUNT NUMBER: 00001447