Become a Member

Member Reactivation

Reactivate Your Membership

Membership Type: *

Duration: *

Member Details

Member Number: *

Email Address: *

Full Name:

Home Phone:

Business Hrs Phone

Mobile Phone

Fax:

Emergency Contact Name:

Emergency Contact Number:

Residential Address

Address:

Suburb / Town:

State:

Postcode:

Country:

Postal Address
Same As Residential Address?

Address:

Suburb / Town:

State:

Postcode:

Country:

Medical Declaration

Are you over 75 OR do you have any of the following conditions:

Epilepsy
Diabetes
Heart condition/disease or paralysis
Mental illness (medicated or otherwise)
Any other medically significant safety related condition?

5. Additional Details

Nominated Flight Training Facility *

Do you hold a CASA issued flight crew licence or equivalent from another organisation? *

Payment

I understand that online transactions incur fees. I wish to help further by giving a little extra ($1.50).

Cost

GST

Reactivation Fee

$

Total

$

On successful payment your membership will be reactivated immediately.

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