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2024 Member Information Form
2024 Member Information Form
2024 Pilot Information
2024 Pilots information
Name
(Required)
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
Prefix
First
Middle
Last
Suffix
Email
(Required)
Preferred Phone
(Required)
Spouse's Name / Emergency Contact
Spouse/Emergency Phone
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Member Type
Pilot (active)
Pilot (inactive)
Observer
Retired
FAA Certificate #
Total Time
Ratings / Endorsements
PPL
Instrument
CFI
CFII
CFI-MEI
Commercial
ATP
Multi-Engine
Tailwheel
High Performance
Remote Pilot (part 107)
Complex
Seaplane
Helicopter
High Altitude
Select All
Acceptable Missions
Search and Rescue
Prisoner Transport
Administrative Transport
Photo/Recon/Surveillance
IFR Flights
Night Flights
Firewatch
Homeland Security
Observer
Check Flights
Not flying
Date of Last BFR
MM slash DD slash YYYY
Medical Class
First
Second
Third
Basic-Med
Date of Last Medical
MM slash DD slash YYYY
Date of Medical Expiration
MM slash DD slash YYYY
Primary N-Number
Second N-Number (if applicable)
Total time in primary aircraft type to be flown
Total time in second aircraft type to be flown (if applicable)
Time in the last 12 months in primary aircraft
Time in the last 12 months in second aircraft (if applicable)
Primary Aircraft Insurer
Primary Aircraft Limit of Liability in dollars
Second Aircraft Insurer (if applicable)
Second Aircraft Limit of Liability in dollars (if applicable)
Make of Aircraft Flown Primary
Beechcraft
Cessna
Grumman
Vans
Arion
Model of Aircraft (Primary)
PrimaryAircraft Est. Hrs of Use per year
Date of Last Annual Inspection for Primary Aircraft
MM slash DD slash YYYY
Make of Aircraft Flown Second
Beechcraft
Cessna
Grumman
Vans
Arion
(if applicable)
Model of Aircraft (Second)
(if applicable)
Second Aircraft Est. Hrs of Use / per year
(if applicable)
Date of Last Annual Inspection for Second Aircraft
MM slash DD slash YYYY
(if applicable)
Detail Page from Insurance Binder
Accepted file types: jpg, png, pdf, Max. file size: 20 MB.
Copy of insurance that includes company name, insurance totals and pilot coverage.
Pilot Certificate
Accepted file types: jpg, png, pdf, Max. file size: 20 MB.
BFR
Accepted file types: jpg, png, pdf, Max. file size: 20 MB.
Copy of logbook with instructor's signature
Copy of Medical/Basic Med Cert
Accepted file types: jpg, png, pdf, Max. file size: 20 MB.
Other document not listed
Notes (anything that might need an explanation)
Acknowledgement of Requirements For Pilot-In-Command
I agree to the policy.
ACKNOWLEDGEMENT OF REQUIREMENTS FOR PILOT-IN-COMMAND: Members intending to act as pilot-in-command on Aero Squadron Missions are required to accept the following acknowledgement: I agree that, when accepting or conducting a mission as Pilot-in-command for the Aero Squadron, I will be in compliance with all acceptable Federal Aviation Administration Regulations regarding pilot qualifications and aircraft airworthiness.
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