Please print or type the information requested:

Name _________________________ Title ______________

Company _________________________________________

Address __________________________________________

City _____________________ State ________ Zip _______

Phone ___________________ Fax _____________________

E-mail Address ____________________________________

Organization Web Site ______________________________

Please renew my membership for:
1 year ($50) 2 yrs ($100) 3 yrs ($150)
(Paying 2 or more years ahead protects you from any dues increase)

Please add my tax-deductible contribution of to the Aero Club to help support the Aero Club Foundation’s aviation education initiatives.

Enclosed is my check for $ ___________________________.

Please bill my credit card: VISA or MasterCard only

Card# _______________________ Exp. Date ___________

Signature (for credit cards only)

Any questions, please call Nancy Hackett at 1-800-322-3761 (DC Metro area) or 703-327-7082 (out of state).