American Huey 369 Organization

                            Membership Application

____Individual  Membership - $100.00

____Corporate/Non-Profit Membership - $500.00

____Lifetime Membership - $1,000.00

PLEASE PRINT:

Name: ______________________________________________

Street Address:  _______________________________________

City:  ________________________ST:_______ZIP:___________

Home Phone:  ________________Cell Phone: ________________

Email   Address:_______________________________________

Birthdate: __________ Prior/Current Military:    YES      NO   (Circle one)

If Yes, please provide your military information:

Last Rank in Service:  ____________________

Units Served in: ________________________

MOS: ________________________________

                                      Membership benefits include:

Admission to Hangar/Museum

Newsletter – Huey News is available at www.americanhuey369.com

Invitation to all Events

Membership Card

American Huey 369 apparel discounts

Are you interested in being a Volunteer/:      YES     NO      (Circle one)

All members are essential to our mission and are able to accompany us

on our flights on a space available basis.

FOR OFFICIAL USE ONLY:  

Date:  __________Event: _________Membership Number:  _______