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Membership Application

Name:

Address:

City:

State:
ZIP:
Phone:

E-mail:
Date Soloed:

Instructor (Optional)
Make and Model Helicopter you soloed:

Where did you solo?

Additional Qualifications or Information (Optional, but feel free to attach photos, clippings, biographical info., etc.)






Print this page, fill out and mail
Please include an initiation fee of $20
plus 1 year annual dues of $10

Make check for $30 payable to:
 Twirly Birds

Mail application to:

Dennis MacBain, Secretary/Treasurer
2654  Hill Park Drive
  San Jose, CA 95124-1734