VAA Chapter 16
“Flatland Flyers”
Membership Application
New Member? Renewal ?
Name:
Address:
City State Zip:
Spouse/Significant other:
Phone HM WK Cell:
E-mail:
Note: All chapter corrispondence is via email
National EAA Member Number ( ) Expiration date:
Aircraft Currently Owned/Flying:
Project: Percentage complete 
/ %
/ %Ratings:
Previous Aircraft built:
What would you like to gain from Chapter Membership?
Will you help with? June Fly-in, Tri-Motor Tour Stop, Board or Committee, Young
Eagles?If yes, which event would you like to help with?
If yes, which event would you like to help with? Would you like to make a donation to: Build a hangar campaign? General
fund? VAA Chapter 16 is a 501c3 organization. Any donations are tax
deductable. Follow this link to donate. Donation Page
Your information will be used by Board and Committee members and to email your newsletters.
I am requesting membership in VAA Chapter 16:
Signature: Date:
Date: VAA Chapter 16. Dues are $20 Annually
Mailing address: VAA Chapter 16, 14810 W. 159th St. Olathe, KS 66062
Thanks for joining us, welcome aboard!
