1790 Route 885, Havelock
New Brunswick, Canada
Click here for COPA:
Date- ___________________________
Name- ______________________________________________________
Address- ____________________________________________________
Postal Code- _____________________________
Tel. Home- ___________________ Cell. _____________________
E-mail - ____________________________________________
Spouse/Partner - _________________________________________
Aircraft - __________________________________________________
Registration- _____________________________________
COPA # - __________________________Exp Date __________
Other aviation affiliations - __________________Exp Date (s) _______________________
License and ratings - ____________________________________
I agree to adhere to the Havelock Flying Club Inc. by-laws and operational directives and I understand that it is a member operated and maintained club and as such my participation in club activities and work efforts will be expected.
Sig. _______________________________________
Approval date - __________________________
Authorized by- ___________________________________ Sig. ________________________________________