APPLICATION FOR MEMBERSHIP
PERSONAL INFORMATION
DATE
Your Full Name
Your Email Address
Webpage (URL)
Street Address (Line 1)
Street Address (Line 2)
City
State
Zip Code
Country
US United States
AU Australia
BM Bermuda
BZ Belize
CA Canada
CF Central African Republic
CG Congo
CH Switzerland
CI Cote D'Ivoire (Ivory Coast)
CN China
CO Colombia
CR Costa Rica
CS Czechoslovakia (former)
CU Cuba
DE Germany
FR France
GB Great Britain (UK)
HK Hong Kong
IE Ireland
IL Israel
IN India
IT Italy
JP Japan
KP Korea (North)
KR Korea (South)
MX Mexico
SG Singapore
SU USSR (former)
UK United Kingdom
US United States
VG Virgin Islands (British)
VI Virgin Islands (U.S.)
ZA South Africa
Your Phone Number (include area code)
Your Fax Number (include
area code)
MEMBERSHIP VERIFICATION INFORMATION
Air Force
Theater of Operations
Group/Wing
Squadron
Dates of Service
Cadet Class
ANNUAL DUES:
$25.00 (Jan. 1 - Dec. 31)
ADDRESS CHECKS TO:
40th FIGHTER
/
FLIGHT TEST SQUADRON ASSOCIATION
MAIL CHECKS TO:
TREASURER
40th FIGHTER
/
FLIGHT TEST SQUADRON ASSOCIATION
Ernest
L. Jordan
162 Brookside Dr.
Mandeville, LA 70471-3202
Tel: 985-624-4970
linojordan@bellsouth.net
Your Printed Name
Your Signature
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