SES Application

SES Membership Application
AMA Membership Required
Fill in the blocks below and then click the Submit Form button below


First Name:
Last Name:
Middle Initial:
Street:
City:
State:
Zip Code:

Home Phone:
Cell Phone:

E Mail Address:

AMA Number:
IMAA Number:
IMAC Number:
SPA Number:
Do you fly solo?	Yes No
Years Flying Solo:
Need a flight Instructor?	Yes No
I am a flight Instructor:	Yes No
Do you now or have you	belonged to another club
	Yes No

Individual Membership:	$60.00
	Over 18 years old

Family Membership:	$90.00
	Applicant, Spouse & Children under 18

Junior Membership:	$10.00
	Under 18 years old

Initiation Fee:	$50.00
	See below

Click Button :

New members pay a one time initiation fee of $50.00

and receive a club monogrammed hat, name tag and info packet

New members only dues are prorated at $5.00 per month
for the current year only

Make checks payable to Southern Eagle Squadron and mail to

Southern Eagle Squadron

P. O. Box 492005

Leesburg, FL 34749-2005