Membership Application

Women in Aviation, Space City Chapter; chapter of Women in Aviation, International
Membership Application

Date __________________

Dues Paid $____________

WAI membership # ____________(if applicable)

Expiration date _________________(if applicable)

Name _______________________________________________________________________________

Address _____________________________________________________________________________

City __________________________  State  ___________  Zip code  _____________________________

E-mail Address _______________________________________________________________________

Telephone ______________________(h) ________________________(c) _____________________(w)

Fax Number ______________________ Birthday: Month ______________ Day _________

Employer ____________________________________________  Position ________________________

Do you have any experiences you would like to share with the members of the organization? (for instance: served on interview board; human resources background; served on accident investigation committee; etc)

__________________________________________________________________________________________

__________________________________________________________________________________________

Aviation Interest ___________________________________________________________________________

Certificates and Ratings _____________________________________________________________________

_________________________________________________________________________________________

The best way to get to know the other members and to help the organization succeed is to get involved, volunteer your time and join a committee. Please check the committees you are interested in. This does not constitute a commitment; a Board member will contact you to explain the function and goals of that    committee.

Committees: ____Membership ____Outreach/Programs ____Finance ___ Fundraising
Other Service: ____ Speakers Bureau ____ Computer Skills

                        ____ Advisor (knowledgeable in _______________________________________________)

Program Suggestions_________________________________________________________________________

__________________________________________________________________________________________

What do you hope to gain from your Space City Chapter of WAI membership? __________________________

__________________________________________________________________________________________

Referring Member’s Name  (if applicable)__________________________________ WAI # ____________

Signature __________________________________________________ Date _________________

Dues payment (circle one):

    Individual $64. Student Dues $44. Family member $30 (does not include Aviation for Women magazine).

NOTE: Chapter dues are separate and in addition to WAI dues.  Membership in WAI is required. Dues payment includes both, chapter and national dues.

Application and payment may be submitted at a meeting or mailed to:

Shari Frisinger
P.O. Box 57996,
Webster, TX. 77598-7996

Checks should be made payable to Women in Aviation, International.