Membership Application

Name:
Address:
City:	State:	ZIP:
Phone:	E-mail:
Date Soloed:	Instructor (Optional)
Make and Model Helicopter you soloed:
Where did you solo?
Additional Qualifications or Information (Optional, but feel free to attach photos, clippings, biographical info., etc.)
Print this page, fill out and mail Please include an initiation fee of $20 plus 1 year annual dues of $10 Make check for $30 payable to:  Twirly Birds	Mail application to: Dennis MacBain, Secretary/Treasurer 2654  Hill Park Drive   San Jose, CA 95124-1734