ALL NEW OR RENEWAL MEMBERSHIPS

Membership and Release of Liability Forms must be completed by all applicants.

Member Information (Application) Form, Rev. 2011-2012 Season

(Application for Membership)  (required)

Release of Liability Form (required)

Include a check for $35, single, or $50, family & Mail.  See Note below about the

advantage of Family Memberships.

Contact the coordinator of your Specialty -- Specialty Coordinators --and introduce yourself.   Our Coordinators are volunteers and may not have noticed your name appearing on the membership list.

Professional Resume' (CV)  (required - in addition to Member Info & waiver)   

complete and print and mail

Current Professional License    (U.S.mail  - in addition to Member Info, check & Waiver)

Mail copy with application

Pilot and Aircraft Information Form (required - in addition to Member Info)

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  PILOT ACKNOWLEDGEMENT - (required to act as PIC on Sam's trips

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Mail copy

Name Badge Order Form (optional)

Sams Logo Items Order Form (optional)

Become a Flying Samaritan Family.  For just fifteen dollars  ($15) you can add all of your family members who reside within your household to your Flying Samaritans membership.  By doing this you will not only help financially support our Chapter, but you will also be ready when one of those special  trips come along where you would like to include your family members.   Add your family members names to the Membership Information form and write your check for $50 instead of $35.  DO IT TODAY !