Application for Membership with NZAWA

CONTACT INFORMATION

Family Name (required):
First Name (required):
Address:
Postal Address
Your Email (required):
Phone:
Mobile:

WHAT AREA OF AVIATION ARE YOU INVOVLED WITH?

Recreational:
Professional:

QUALIFICATIONS AND RATINGS

Aviation Qualifications held:
Date gained:
Ratings held:
Date gained:

HOURS LOGGED

Total Hours logged:
PIC:
Hours logged in last calendar year:
PIC:

ADDITIONAL INFORMATION

Which club, school or organisation do you fly at?:
Other aviation memberships or interests:

OPTIONAL PERSONAL DETAILS

Occupation:
Date of Birth:
Any special skills which you would be prepared to share with the NZAWA :
Any other information or questions:

PAYMENT DETAILS:
Cheque Direct Debit Visa or Mastercard 
Note:
Cheques payable to NZAWA, PO Box 10-262, Wellington
Direct Debit 03-0399-0078431-00
We accept Visa or MasterCard

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