IFFR MEMBERSHIP APPLICATION FORM

IFFR MEMBERSHIP APPLICATION FORM

AUSTRALIAN SECTION. For any questions or queries please contact iffraust@gmail.com
NAME*

First NameSurname
PREFERRED NAME
SPOUSE OR PARTNER'S NAME (If Applicable)
ADDRESS*

Street Address

Street Address Line 2

CityState

Post Code
CONTACT PHONE NO*
Please enter a valid phone number.Format: (000) 000-0000.
EMAIL*
example@example.com
ROTARY CLUB (if Applicable)
ROTARY CLASSIFICATION (if Applicable)
BUSINESS / PROFESSION*
HOME AIRPORT *
AIRPORT CLASSIFIER
Y-
AIRCRAFT MAKE / MODEL
AIRCRAFT REGISTRATION (IF ANY)
VH-
LICENCE & RATINGS HELD (IF ANY)
(Special Offer) $100 for 5 yearsSTANDARD SUBSCRIPTION- $25 per annum
Once you have completed this form, please make a payment directly with your membership amount to-
- IFFR (AUSTRALIA) INC.
- SUNCORP BANK BSB: 484799 Account No: 03779 5513
After payment please email your name & reference to our Secretary: lynneduckham@gmail.com
COMMENTS (If Any)
SIGNATURE (Print Full Name)*
Please verify that you are human*
Should be Empty: