IVOG MEMBERSHIP FORM

Print out this form, complete & mail form and cheque to
Gary Robinson 2640 Obelisco Place, Carlsbad, CA 92009, USA

DUES are $15.00/year North America ($27.00 US Foreign)

Date________________

Pilot___________________________________

Occupation______________________________

Spouse__________________________________Pilot Yes/No

Kids/Age at Home____________________________________

Address_________________________________

City____________________________________

State/Prov/Country______________________

Zip/Postal Zone________________

Phone #s Home________________ Work________________ Email_______________

Home Airport_________________________________ ID___________

Co-Owner___________________________________

Aircraft N Number______________

Year____________ Model____________ S/N_____________
Year Acquired____________
Special Equipment___________________________________________________

Will you host a fly-in? Yes/No Day/Overnight
Do you have a story or experience to share? Yes/No
Do you have any maintenance tips to share? Yes/No
Comments or Suggestions_________________________________________________
____________________________________________________________