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EAA CHAPTER 27 MEMBERSHIP FORM

Please fill in the following information and mail with your dues to:
EAA Chapter 27, c/o Bill Jagoda, 43 Derby Road, Rockfall, CT 06481
Dues are $20.00 per year, due on January 1. Make checks payable to EAA Chapter 27

(Please print)

Name: _____________________________________________________________________________________

Street: ___________________________________________________________________________________

City: __________________________________________________  State: _____ Zip: _______________

National EAA Member # ____________________________________Expires: ________________________

E-mail address: ___________________________________________________________________________ 
We only send our newsletter via email

Home Phone: ___________________________________  Cell Phone: ______________________________

Airplane(s) experience, built, building or owned: _________________________________________

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Skills and Knowledge you're willing to share: _____________________________________________

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