Membership Form - Montana Pilots Association

Montana Pilots' Association

NEW Membership Application Form

If you are already a Montana Pilots Association member,
please click here to log on first.
Your renewal form will be displayed after you log on.

Membership includes full website access and MPA Heading Bug, 6 issues per year.

Please fill in all the areas below (BLUE BOLD are required). Check any "Hide" box to hide that information from the MPA members view of the website and rosters. Then select one of the two payment methods:

Pay by Mail - if selected, a copy of the application form will be printed out.
Enclose it with your check payable to Montana Pilots Association and mail it to:
    Geanette Cebulski
    Montana Pilots Association
    P. O. Box 1178
    Seeley Lake, MT 59868-0333
Membership begins upon receipt of payment.
Pay by Credit Card - if selected, you will be prompted for your Credit Card or PayPal account information.
Membership begins on the 1st of the current month.

New members will be granted an immediate, temporary 30 day period to access the "Members Only" portions of the Club website. A random password will be assigned and e-mailed to you.

2/8/2012

Address Information

First Name

Last Name

Spouse Name

Company
(Corp. members only)

View USPS addressing rules

Street Address

Hide

Address Line 2

Hide

City

State

ZIP + 4 (example: 12345-7890)
Find Zip + 4 at the USPS website.

Home Phone

Hide

Work Phone

Hide

Cell Phone

Hide

E-mail Address

Hide

Occupation

Send Printed Newsletter

Select applicable MPA Hangar

You may also choose to be a "Member at Large"

Check here if you are pilot rated

Principal Airport Flown From

Airport ID

ONE airport only and exclude any leading "K"

Aircraft Owned

Add a new aircraft here.

Make/Model

Year (yyyy)

Reg. Number (incl. "N")

Special equipment
or comments

Referred By

Please select one of the following options.

MPA member: (Name)
Poster at airport
Event
3 month trial
Other

Details: (For example: who referred you, what event were you at, etc.

Volunteer Opportunities

I am interested in serving on these committees:

Social Activities	Legislative	Administration
Recreational Airstrips	Membership	Aviation Issues
Education	Newsletter	Safety Education
Other (Specify):

Membership Type

Please select one of the following options.

Montana First Year Solo Pilot (1st Year FREE)
Req'd Promo Code:
Regular Member (Pilot) $25
Associate Member (not soloed) $15

Please select a membership period to checkout. <- This button will take you to the PayPal system where the initial page will allow you to either enter your PayPal credentials, else click the CONTINUE link seen next to these credit cards.