Membership Application for Experimental Soaring Association ... (4/12/2010 ... last update 7/12/2010)

 Please print the form below, fill out and mail to ESA  

 Please check one:
 ___I would like to join or renew my membership in ESA
 ___Please update/change my information in the ESA database


Name ______________________  SSA # (if member) _______

Address ___________________  Country (if not USA) _______
 
City ____________________ State __________ Zip ________

Email  ________________________

Telephone Number _____________________
 
Sailplanes Currently  Building __________________________________________________

Sailplanes Interested in Building ___________________________________________________
 
Sailplanes have Built/Helped Build ____________________________________________________

Dues (1 year) (U.S. Dollars)   

    US Student Membership (3rd class mail)            $18  (Full-time student, as defined by SSA
    US Regular membership (3rd class mail)            $24
    US First Class Mail Membership                        $33
    All other countries (Surface Mail)                       $32
    Airmail:  South/Central America, Canada           $40
    Europe                                                       $45
    Pacific Rim/Other                                      $50


Make check payable to:  Experimental Soaring Association
Mail to:
     
Murry Rozansky, Treasurer,
    23165 Smith Road
    Chatsworth, CA 91311 USA

Notes:

Questions?  Contact Murry Rozansky ... 

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Address of this webpage:  http://esoaring.com/application.htm
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Copyright © 2005 by Experimental Soaring Association, all rights reserved.