Membership Application Form

New Member Application Form

If you are already a KPA member, then click here for renewal form.

Enter the following information which will be maintained in the KPA Membership Database. Then press the Print Application button at the bottom of this page and mail the completed form to the address below. Please include your check payable to the Kansas Pilots Association with your annual $20 dues payment (and to be renewed in June of each calendar year).

If you have questions, contact the Secretary using the Contact Us button at the left. Your check must be received before the application can be processed. However once this online form is submitted, you will be granted temporary access to "Members Only" portions of our website.

Contact information NOT marked "OK to show" will not be shown on this website, even to our members. All information is confidential and will not be distributed to outside organizations or solicitors. Your Email address is used to access "Members Only" portions of our website, www.kansaspilots.org, and also for important notices.

Address & Contact Information (* are required)

Your Name*:

First

Last

Spouse Name:

Street Address*:

OK to show?

City

State

ZIP

E-mail Addr:

OK to show?

Home Phone:

OK to show?

Work Phone:

OK to show?

Cell Phone:

OK to show?

Fax Phone:

OK to show?

Home Airport:

Do not include the K prefix

Flight Qualifications

License:

Instrument Rated

CFI/Ratings:

SEL

MEL

SES

MES

Cat/Class:	SEL	MEL	SES	MES
	Helicopter	Gyroplane	Powered Lift
	Glider	Airship	Balloon

Mechanic License:

Airframe

Powerplant

Airframe Inspector