Membership Information

Membership Application

Personal Information

First Name

Last Name

Phone/Mobile

Address

Address Line 1

Address Line 2

City

State

Zip Code

Date Of Birth

Military Service

Military Service (Branch)

Military Service Current Status

Active

Reserves

Retired

Pilot Information

Pilot Certificate Number

Date Received

Ratings

Check Ratings And Licenses Held Below And Give As Accurate An Estimate Of Time As Possible For Each Item.

Airplane Single Engine Land Time

Airplane Single Engine Sea Time

Airplane Multi-Engine Land Time

Airplane Multi-Engine Sea Time

Instrument Single Engine Time

Instrument Multi-Engine Time

CFI - Single Engine Time

CFII - Single Engine Time

MEI Time

MEII Time

Glider

Rotorcraft

Total Time

Total Time in Last 12 Months

Date of Last BFR

Safety Record

Check Ratings And Licenses Held Below And Give As Accurate An Estimate Of Time As Possible For Each Item.

If you answer 'yes' to any of the safety questions, include a complete explanation showing events, dates, details in the box below. Failure to provide a detailed response(s) will automatically disqualify your application.

Have you ever had any Aircraft/Aviation related losses, claims, violations or suspensions?

Yes

Please Explain

Do you have any physical impairments, waivers or limitations?

Yes

Please Explain

Have you ever been convicted or plead quilty to a DWI or DUI?

Yes

Please Explain

Have you ever been convicted of a felony?

Yes

Please Explain

Upload Documentation

Drivers License File Upload

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Maximum upload size: 516MB

Pilots License File Upload

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Maximum upload size: 516MB

Medical Certificate File Upload

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Maximum upload size: 516MB

Proof of Insurance File Upload

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Maximum upload size: 516MB

Terms & Conditions

I hereby submit my application for membership in the Jack Dunn Flying Club. I understand that my application will first be reviewed by the JDFC Officers and upon review and acceptance, I will be billed for the initiation fee and the first month's dues. A copy of my driver’s license, pilot certificate, and my most recent medical certificate are being provided with this form.

I understand the Membership Initiation Fee is used to purchase a share in the club plane (N64892) and should I withdraw from the club for any reason my share will be for sale and the next new member will in effect buy my share thus refunding my initiation fee.

I understand that billing goes out on the 1st of the month for current month’s flight charges and following month’s dues.

I understand that monthly dues and flight charges are due and payable no later than the 10th of the following month and that a $25 late fee will be assessed monthly for any unpaid invoices.

I am hereby informed that I may automatically lose my flying privileges when I become one month late in paying my dues.

I am further informed that I will be transferred to inactive status if the balance is not paid by the 15th of the following month.

I understand that it is my responsibility to refill the fuel tanks on Club aircraft to the bottom of the filler neck after flight and before parking the aircraft in its hangar.

I understand that cooperative action of members is essential to effective club operation and regular attendance to monthly meetings and club aircraft care days is expected.

I have read and understand the club's By-Laws and General Rules.

I agree to abide by the Club's by-laws, General Rules and any resolutions of the Administrative Board while active as a member of the Club.

I agree to the Terms and Conditions

Yes I Agree