EAA1114 Join-Renew

Join/Renew Member Info

To request membership in EAA Chapter 1114, please fill in this form and hit submit at the bottom. This will send your information to the membership coordinator who will contact you. Also use this form to renew you membership when you have significant changes to your info.

This information is used for your Chapter membership, and is available to other EAA1114 Chapter members in the membership directory, but is not shared outside of the Chapter.

Note: Fields with * are required.

Address & Contact

*First name		*Last name
*Address/Street		*Town/city
*State/province		*Postcode/zip
*Primary phone
Work phone		Cell phone
*Email addr

Personal

*Your National EAA member #		*EAA member expiration (MMDDYYYY or lifetime)
Birth Month (MM)		Birth Day (DD)
Occupation/Profession		Employer
Spouse's name		Children's names
Are you currently a student, if so, what school?		School graduation year (YYYY)

How did you learn about or find our Chapter?	EAA National website Chapter website Blast or other email from EAA SocialFlight Young Eagles event Public event Other
How would you like to contribute to EAA Chapter 1114?	Volunteer help where needed Key volunteer/coordinator Monthly Programs Young Eagles Instructing Newsletter Building Aircraft Maintenance Other
We do two bulk Chapter nametag orders a year. To help guage when we have enough interest to do an order, are you interested in getting a chapter nametag (details to come as we get close to order time)?	Yes No
Include a note to the membership coordinator if desired.

Aviation

Aviation certifications & ratings/endor (e.g. PP:ASEL/Complex, CP:AMEL/Instrument Airplane)
Aviation interests
Current aircraft build/ restoration projects
Current aircraft owned, Type, N#, Base
Previous aircraft owned
Other unique qualifications

Finally, you must click the "Submit" button below to send your
information to the membership coordinator.

Thank you! Click Submit>>