Riverside Pilots Flying Club
"New Member Application Registration"
Please complete the following short form so we can follow up with your new membership request.
New Member Application Registration
First Name:
Last Name:
Email:
Address:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Phone:
Use format like: 555-123-4567
Cell:
Use format like: 555-123-4567
Are you a pilot?:
Click to select
Yes
No
What is your highest rating?:
Click to select
Student
Private
Instrument
Commercial
ATP
NA
Do you own your airplane?:
Click to select
Yes
No
When do you plan on joining the Club?:
Click to select
less than 6 months
6-12 months
Other
How did you hear about us?:
Comments: