PAFT Member Profile

This form is now ready for use - please complete as soon as possible to make sure your information is included.

Information supplied will be distributed only to active (dues paid) PAFT members in hardcopy form;

 it will not be posted on the Web site.  Please note that you have the opportunity to authorize

the publication of each item of information.

 

Click here to check your membership status

 

PRIMARY MEMBER INFORMATION (see below to enter spouse or significant other information).

First Name    

Middle Name or Initial (optional)    

Last Name

Nickname or preferred name for club event name tags     

 

PRIMARY MEMBER RESIDENCE (PHYSICAL) ADDRESS

Residence (Physical) Street Address

Residence City    

Residence State    

Residence ZIP Code

 

PRIMARY MEMBER PREFERRED MAILING ADDRESS

Mailing Address Line 1    

Mailing Address Line 2

Mailing Address City    

Mailing Address State    

Mailing Address ZIP Code 

 

PRIMARY MEMBER PERSONAL CONTACT INFORMATION

Home Phone XXX-YYY-ZZZZ

Alternate Home Phone XXX-YYY-ZZZZ

Home FAX  XXX-YYY-ZZZZ

Personal Cell Phone  XXX-YYY-ZZZZ

Personal Email 

Alternate Personal Email 

Business Cell Phone  XXX-YYY-ZZZZ

Direct Dial Office Phone  XXX-YYY-ZZZZ   Extension 

Business Main Number or Switchboard  XXX-YYY-ZZZZ

Business Email 

 

 

SPOUSE OR SIGNIFICANT OTHER INFORMATION

First Name 

Middle Name or Initial (optional) 

Last Name 

Nickname or preferred name for club event name tags 

 

SPOUSE OR SIGNIFICANT OTHER RESIDENCE (PHYSICAL) ADDRESS IF DIFFERENT FROM PRIMARY MEMBER

Residence (Physical) Street Address

Residence City  

Residence State 

Residence ZIP Code

 

SPOUSE OR SIGNIFICANT OTHER PREFERRED MAILING ADDRESS

Mailing Address Line 1

Mailing Address Line 2

Mailing Address City 

Mailing Address State 

Mailing Address ZIP Code 

 

SPOUSE OR SIGNIFICANT OTHER PERSONAL CONTACT INFORMATION IF DIFFERENT FROM PRIMARY MEMBER

Home Phone  XXX-YYY-ZZZZ

Alternate Home Phone  XXX-YYY-ZZZZ

Home FAX  XXX-YYY-ZZZZ

Personal Cell Phone  XXX-YYY-ZZZZ

Personal Email 

Alternate Personal Email 

Business Cell Phone  XXX-YYY-ZZZZ

Direct Dial Office Phone  XXX-YYY-ZZZZ    Extension 

Business Main Number or Switchboard  XXX-YYY-ZZZZ

Business Email 

 

 

AIRCRAFT INFORMATION

I currently own an aircraft    

Tail Number 

Manufacturer     

Model 

Year  (In the form 19XX or 20XX)

Aircraft is based at  (enter name of airport and airport ID)

I am a partner in this aircraft with  (enter names of partners)

 

I currently rent aircraft

Primary airport 

 

 

OTHER INFORMATION

Please provide other information and comments about what to include (or not to include) in your club directory listing.

(For example, your occupation, type of business owned, hobbies).

 

 

 

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