Prospective CAP Member Interest Form

Prospective CAP Member Interest Form
This form is used to collect membership inquiries to join Civil Air Patrol's Arkansas Wing. Someone from our membership team will reach out soon.
Which Squadron do you live close to? *
Prospective Member Name*

First NameLast Name
Prospective Member Email*
example@example.com
Prospective Member Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Prospective Member Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you Over 18?

YesNo
Parent or Legal Guardian Name (First Last)*
If under 18 years of age
Parent or Legal Guardian Phone Number*
If under 18 years of ageFormat: (000) 000-0000.
Membership Type*

Cadet (youth age 12-18)Adult (age 18+)Cadet Sponsor (parent/guardian)Patron (inactive supporter)Aerospace Education (educator/teacher)
How did you first hear about Civil Air Patrol?*
What aspect of Civil Air Patrol are you most interested in?*
FAA Certificate (If you hold an FAA pilot certificate, please indicate it here.)

Sport PilotPrivate PilotCommercial PilotAirline Transport PilotFlight InstructorRemote Pilot (Part 107)Student PilotA&P Mechanic
Did a CAP member recruit you?
Member Name and/or CAPID #
Message*
Unit Email Contact
example@example.com
Should be Empty: