Join, Renew, or Update Membership • Chicago Executive Pilots Association

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Join, Renew, or Update Member Information

Action *

New member
Renewal
Member information update

Membership Number (if known)

Gift Membership

Donor Name

First

Last

You may leave blank if you wish your gift membership to be anonymous.

Member Name *

First

Middle

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

ZIP code required if participating in FAASafety WINGS program

Phone

Phone number type

Mobile
Home
Work

Email address (preferred for communications with CEPA) *

FAA WINGS Email Address (if different than above)

Pilot Certificate

Student
Private
Commercial
ATP

Ratings

Instrument
Multi
CFI
CFII
MEI
Glider
Rotorcraft
Lighter than Air
Turbine
Type(s)

Non-Flying Member

Neighbor
Enthusiast
Mechanic/Technician
ATC
FAA
Other

Total Hours

Years Flying

Years flown at Chicago Executive Airport

Flying Organizations

AOPA
EAA
NBAA
Type club/association
SPA

What Flying Club(s) do belong?

Plane(s) owned (N-number, Make/Model)

Yes, I want to volunteer!

Committee Member
Board Member
Special Project

Comment or Message

Multiple Items *

Full Membership - $40.00
Student Membership - $15.00
Associate Member - $15.00

Phone

If you have any questions, please email our membership chairman at: membership@pwkpilots.org

If you prefer mailing in a check for your dues, please download and return the completed application form. You may include a donation to our 501(c)(3) scholarship fund in the same mailing. Download