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