Apply for Membership

Complete the form and attach all required supporting documents before submitting the form. Supporting documents may include your driver's license, DMV driving record, pilot certificate, and medical certificate if applicable. Your submitted documents will be safely stored and not accessible to the internet public.

Applicant Information

First name:

Middle initial:

Last name:

Date of birth:

Primary Email:

Mobile:

Driver's License Number:

Driver's License State:

Emergency Contact (optional)

Provide details for someone we can contact in case of emergency.

Emergency Contact Name:

Relationship:

Emergency Contact Phone:

Address

Address:

City:

State:

Zipcode:

Country:

How long have you lived at your current address?

Do you own your home?

If Other, please explain:

Pilot Information

Pilot Certificate Held (ASEL):

Pilot Certificate Number:

Pilot Certificate Issue Date:

Ratings / Endorsements earned Instrument Tailwheel High Performance Complex

Hours in Tailwheel Airplanes:

Hours in Complex:

Do you have a rotorcraft certificate?

Total Hours as PIC (ASEL):

Hours as PIC (ASEL) in past 90 days:

Supporting Documents

Driver's license photo or scan:

Required. JPG, PNG, HEIC, HEIF, or PDF. Maximum size: 25 MB.

Pilot certificate - front:

Required unless Pilot Certificate Held is None. JPG, PNG, HEIC, HEIF, or PDF. Maximum size: 25 MB.

Pilot certificate - back:

Required unless Pilot Certificate Held is None. JPG, PNG, HEIC, HEIF, or PDF. Maximum size: 25 MB.

Current medical certificate:

Optional. Upload if applicable. JPG, PNG, HEIC, HEIF, or PDF. Maximum size: 25 MB.

Current DMV driving record:

Required. JPG, PNG, HEIC, HEIF, or PDF. Maximum size: 25 MB.

Club and Background Information

How long do you expect to be a member?

If Other, please explain:

Current Employment:

How did you find the K-State Flying Club?

List and explain traffic citations in the past 5 years:

Have you been convicted of DUI in the past 5 years?

Have you ever been convicted of a felony?

Have you ever been involved in an aircraft accident as Pilot in Command?

Have you ever had FAA enforcement action taken against your pilot certificate?

Have you previously been a member of K-State Flying Club?

Additional explanations:

Use this for explanations related to any yes answers or other application notes.

Acknowledgments

I have read and understand the current club Bylaws and Policies and Procedures Manual. I agree to treat the club aircraft and assets with care and respect. I understand that submitting false information subjects me to immediate forfeiture of club membership.

Spam Protection

Please complete the verification before submitting your application.

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