Silent Knights, Inc.  Membership Application

Ames Municipal Airport, Ames, Iowa

 

Name: ________________________________    __________________________________    _______

            (last)                                           (first)                                                 (middle initial)

 

Mailing Address: ___________________________________________________________________

 

 

(City) __________________________________     (State) __________   (ZIP) _____________________

 

 

Email: ___________________________________

 

 

Tel: (home) __________________________ (office) _________________________

 

 

(mobile) _____________________________

 

 

Employer: ________________ Occupation: __________________________________

 

 

Emergency contact: _________________________________,       _________________________

                                (name)                                               (relat.)

 

____________________________

(phone)

 

Soaring Society of America membership #:__________________________________________

Membership in SSA is required before exercising flight privileges

 

FAA pilot license grade and # (if any) _______________________________________________

 

Biennial date: (for currently licensed pilots) _________________________________________

 

Physical grade & date: (optional for glider-only pilots) ______________________________

 

Membership applied for:

 

___ active ($500 and $25/mo. dues)

 

___ time-pay active ($100, $10/mo. and $25/mo. dues)

 

___ high-school, college student ($144, no dues first year)

 

___ associate ($5/year, no flight privileges; may serve as tow pilot)

 

___ family (free for children under 18 or spouses of active members)

 

 

I agree to help with club activities whenever I can because I understand that the Silent Knights glider club only functions with the participation of its members.  I also agree to waive any claims I may ever have against the Silent Knights, its officers, and members for any act of negligence.  I agree to pay my account in full each month and understand that flying privileges are suspended if an overdue balance exceeds $50, unless the Treasurer agrees.  I agree to read and comply with the club by-laws, the standard operation procedures, the Code of Federal Regulations as well as other applicable state and local laws.

 

 

_________________________________________________     __________________

Signature                                                                 Date

 

______________________________________    ___________________________________     ________________

Approved by                                          Club officer                                         Date

 

Please attach a check payable to Silent Knights, Inc. and either give to a club officer or mail to the treasurer:

 

Silent Knights, Inc.

Harry Davis

5884 Dogwood Lane

Johnston IA 50131

 

Club Officers

Kim Kirschman, President .............. 515-771-2347

Paul Kaufmann, V-P .............. 515-291-3085

Harry Davis, Treasurer .............. 515-281-1931

Kelley Farrar, Secretary .............. 515-291-1654

 

Reimbursement Rates  (subject to change)

 

Current Prices

Schleicher K7: $8/flight         2-22: $5/flight             Tows: $1.60/100 feet

 

 

Silent Knights, Inc.  Resignation Request

I hearby request to terminate my membership in Silent Knights, Inc.  I understand that membership termination does not relieve me of responsibility for past-due payments and any other charges that may be due.

 

________________________________________________    ___________________

Signature                                                              Date

 

 

_____________________________________      _______________________________    ________________

Approved by                                           Club officer                                 Date