Ohio Chief Association Membership Information Survey

 

Please complete and return to:

Brian W. Matz

3978 Meadowbrook Blvd.

University Hts., OH 44118

 

 

Name and Address:

 

 

 

 

1)  Your Phone Number(s):

 

 

2)  Your E-Mail Address:

 

 

3)  Your Home Base Airport:

 

 

4)  Your Aircraft:      

   

Year	Model	N Number	Serial Number

 

 

5)  Your Total Flight Time:

 

 

6)  Your Total Tailwheel Time:

 

 

7)  Are you a CFI?                       Yes                  No

 

                If Yes, do you actively instruct?       Yes         No

 

 

8)  Are you an A&P?       Yes                             No

 

 

                If Yes, do you have a particular specialty?

 

 

 

 

9) Do you belong to any other Aeronca type clubs?  If so, which ones and what are the strengths and                

    weaknesses?

 

 

 

 

 

10) What, in addition to the Fly-In, would you like to see provided by the Ohio Chief Association?