Bald Eagle Flying Club
Online Club Application
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Online Application Form:
Apply online using the form below. This will function as an initial application, however, after we have contacted you, we will need to recieve a copy of your current FAA medical certificate, a copy of your pilot certificate (if applicable), and a copy of the last page of your logbook. After application, the financial commitments will be $450 initiation fee, $300 corporation stock (refundable upon resignation from club), and $75 first months dues. After you submit your application, we will try to contact you within a week, if you are not contacted in a timely fashion, contact someone (information available on the contact us page).

Name
Date of Birth
Citizenship
Street Address
Apt./Unit
City
State
Zip Code
Day Phone
Evening Phone
Cell Phone
E-mail Address
Employer
Emergency Contact Name
Relationship with Contact
Contact Phone Number
Date of Medical Certificate
Med Cert Number
Number of Dual Hours
Number of Solo Hours
time cross country
Date of First Flight
Date of Last Flight
Name of Last Instructor
His FBO or Employer
Motor Vehicle Moving Violation
FAA Certificate Number
what certificate
Other Certificates and Ratings
Date of Last Medical
Date of Last BFR
Total Hours as PIC
Last 12 months hours
Last 3 months hours
Landings in the Last 3 Months
year of PP checkride
Training Location
FAA suspension actions
Motor Vehicle Violation Report
Flying Reference and Contact #
total 172 hours
last 6 months 172 hours
total high performance
last 6 hp
complex total field
last 6 months complex
Hours in Other Categorys:
categorys
how many hours
Bald Eagle Flying Club
P.O. Box 1713
Portland, ME 04104