Join LEFC!

Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you a US Citizen *

Yes

No

I have a current pilot's license *

Yes

No

PIlot Certificates Held

Student

Sport

PVT

COM

ATP

CFI

CFI-I

Instrument Rated *

Yes

No

Medical Expiration

MM

DD

YYYY

Last Flight Review

MM

DD

YYYY

Were you referred by a current LEFC Member?

Yes

No

Has your driver's license ever been revoked or suspended

Yes

No

Have you been involved in an aircraft incident / accident? *

Yes

No

As PIC or SIC, have you been found guilty of violating a Federal Aviation Regulation?

Yes

No

Have you ever been arrested for operating an automobile under the influence of alcohol or drugs?

Yes

No

Why Do You Want To Join Leading Edge Flying Club?

Airport Location

Weekend Plane Rental

Weekday Plane Rental

Multi-day Plane Rental

Looking for Social Environment

Wanting to "leaseback" my plane

Other

Emergency Contact

First Name

Last Name

Emergency Contact Phone Number *

(###)

###

####

Interested in serving the club

Legal/Insurance/Bylaws

Technology

Maintenance

Membership/Activities

Financial

Other

I declare that the representations of fact contained in the foregoing application are true and correct. I agree that if any information herein contained is false, the acceptance of membership made on the strength of this application may, at the option of the Board of Directors, may be terminated at any time.

I agree

Applicants are advised and agree that the Flight Club may investigate to the extent reasonably necessary the Applicant’s worthiness for membership, and gives permission to seek reports from any governmental entity or law enforcement agency.

I Agree

Aircraft renter’s insurance is a club requirement. Members are required to acknowledge their responsibility for the deductible and up to $5,000 in loss of use liability for each club aircraft’s coverage in case of accident or incident.

I Agree

I understand that any false statement in this application or violation of rules is grounds for forfeiture of membership without recourse. I understand that I am responsible for knowing the club rules before flying and that I may not fly a Club aircraft solo until checked out by an authorized LEFC Club Member CFI and approved by the Board of Directors.

I Agree