For Addition Questions Contact:
Rick Briggs
Airspace Place Business Office
c/o 815 E. Tallmadge Ave.
Akron, OH 44310
330-633-7770

Print Out and Fax to:

330-633-0006

Name

 

Address

 

City

State

 

Zip

Home Ph

 

Work Ph

Email Address

 

Cell Ph

 

 

 

Type of Aircraft Flown:

 

Make

 

 

Model

Based At

 

Hours Flown
per Year

 

 

 

 

Ratings

 

 Student Private Instrument

 

 

 Commercial CFI Multi-Engine

 

 

 Glider CFII Rotorcraft

 

 

 

Sponsoring Members:

 

1
2

 

 

 

Areas of
Interest to Help:

 

Trip Planning Cooking Pancakes

 

Accounting Exterior Maintenance

 

 

PR Newsletter Interior Maintenance

 

 

EAA Young Eagles Flight Instruction

 

 

Organizing Social Events

 

 

Membership Fundraising

 

 

 

By submitting this form you agree to abide by all club guidelines and to maintain security and cleanliness of the club. I understand my access card is for my use or that of my immediate family only and its unauthorized use is cause for revocation. I agree to turn off the lights, turn down the heat/AC when the club is not in use and to clean up any messes myself or my guests may make. I understand there is a charge of $25.00 for lost or replacement cards.