Oregon State Flying Club, Inc. Membership Application

Please fill out the application below. Upon submission a copy of your application will be emailed to you and Bob Parrott (Club President). Please make an appointment with Bob to complete your application.

Please bring the following to the appointment.
- Proof-of-eligibility (OSU or LBCC class schedule, transcripts, staff ID, etc.)
- Driver's License
- Check or credit card for joining costs
- FAA Certificates & Medical (if you are already a pilot)

Name Name First Last
Email
Birth Date Birth Date / MM / DD YYYY
Affiliation
Have you been a Oregon State Flying Club member in the past?

Have you been a Oregon State Flying Club member in the past? Yes No
Driver's Licence Number
Driver's Licence State\Country
Local to Corvallis Address Local to Corvallis Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Permanent Address (if different from local address) Permanent Address (if different from local address)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone (mobile) Phone (mobile) - ### - ### ####
Phone (home) Phone (home) - ### - ### ####
Phone (work) Phone (work) - ### - ### ####
List two people who would be able to contact you after leaving OSU or LBCC or OSFC.
Contact Person 1 Contact Person 1 First Last
Address of Contact Person 1 Address of Contact Person 1
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone of Contact Person 1 Phone of Contact Person 1 - ### - ### ####
Contact Person 2 Contact Person 2 First Last
Address of Contact Person 2 Address of Contact Person 2
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone of Contact Person 2 Phone of Contact Person 2 - ### - ### ####
Pilot Information
FAA Certification Type
FAA Certificate Number
Date Certificate Issued Date Certificate Issued / MM / DD YYYY
Ratings (relative to OSFC aircraft, check all that apply)

Ratings (relative to OSFC aircraft, check all that apply) Instrument Instructor Instrument Instructor
Last Flight Review (BFR) Date Last Flight Review (BFR) Date / MM / DD YYYY
Last FAA Medical Date Last FAA Medical Date / MM / DD YYYY
Class of last FAA Medical
Have you ever been involved in any aircraft accidents or incidents, or had your license suspended?

Have you ever been involved in any aircraft accidents or incidents, or had your license suspended? Yes No
Describe accident(s), incident(s), or the circumstances leading to license suspension(s).
OSFC Membership Agreement

I hereby apply for membership as a flying member of the Oregon State Flying Club, Inc. and have read and agree to abide by all of the OSFC Bylaws, Resolutions, & Rules. I realize that I will be expected to work with others to case scheduling problems, as I would want them to do for me. I will, when called upon, help with the cleaning and washing of aircraft. I understand that if I damage the OSFC equipment, I will be expected to pay the difference between the insurance settlement and the actual cost of repairs.

I acknowledge that the cost of flying time and OSFC dues constitutes a legal debt and promise to pay these debts in accordance with provisions of the OSFC Bylaws, Resolutions, & Rules. I further understand that any outstanding balance on my account over 30 days old will be assessed a finance charge of 1.5% per month (18% A.P.R.) subject to a $.50 minimum. I agree to pay any expense the OSFC incurs collecting an overdue balance on my account.
Type your full name as an electronic signature for the OSFC Membership Agreement.
Agreement for Participation in the Oregon State Flying Club, Inc. (OSFC)

I wish to participate in the OSFC. I acknowledge and understand there are risks of personal injury involved in this activity that I have agreed to accept responsibility for. I understand the dangers and perils involved and safety precautions and rules I am to follow to minimize the chance of injury. I agree to follow these rules (both FAA and OSFC).

In consideration of being allowed to participate in any and all OSFC activities, I myself, my heirs, executors, administrators and assigns, do waive, release and discharge any and all rights, demands, or claims for damage and cause of suit or action, known or unknown, that I may have against the State of Oregon, Oregon State University or their employees or agents, and the Oregon State Flying Club, Inc. for any or all injuries in any manner resulting from such participation. I attest and verify that I have full knowledge of all risks involved in the activity and will through my own resources, including insurance benefits, assume and pay my own medical and emergency expenses in the event of accident or illness, regardless of whether I have authorized such payments.
Type your full name as an electronic signature for Agreement for Participation in the OSFC, Inc.

Oregon State Flying Club, Inc. Membership Application

Oregon State Flying Club, Inc. Membership Application

List two people who would be able to contact you after leaving OSU or LBCC or OSFC.

Pilot Information

OSFC Membership Agreement

Agreement for Participation in the Oregon State Flying Club, Inc. (OSFC)