Membership / Renewal Form

         Washington Seaplane Pilots Association

Name: ________________________________________________

Address: ______________________________________________

City: __________________________________________________

State: ____________ Zip: ________________

Phone: ____________________

Email Address: _________________________________________ (required for communications)

Airplane: N#: _______________Type: _______________________

Calendar Year for Membership (please circle) 2015 2016 2017

 ________Memberships @ $30 ea = $ ________________

 Open Water Legal Fund Donation:   $ ________________

                                              TOTAL: $ ________________

 Make check payable to: WSPA