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TIC170A Membership Application (You don't have to be an airplane owner or pilot to join)
Fill in as much information as you can (even if you are only renewing). The required fields are underlined.
Follow one of the two procedures listed below, depending on your payment method. Please allow 1-2 weeks for processing.
Please select the payment method before you print or send the form. Call HQ at 307-587-6397 with questions or Credit Card info.

Pay via PayPal®. Fill in the form contents which will be sent to headquarters automatically when you click the "Pay via PayPal®" button at the bottom of the page. You will then be directed to the PayPal® site for payment. This is the easiest, and preferred, method. Do NOT fill in the Credit Card info on this form if paying by PayPal®. You do not have to have a Paypal® account to use your credit card via Paypal®.

OR

Fill in the form and print it. Include credit card info (VISA MC, Discover or AMEX only), and sign it or include a check for $45 ($130 for 3 yrs)(US Funds) payable to:
    The International Cessna 170 Association, 22 Vista View Lane, Cody, WY 82414-9606
Or if using credit card fax completed form to 307-587-8296.

New Member or Renewal  (Member No.).....$45 - 1 yr or $130 - 3 yrs
If your membership has lapsed for more than 6 months, please select New Member.

First Name:
Last Name:
Spouse's Name:
Address1:
Address2:
City:
State/Province:
Zip/Postal:
Country:
Phone (123-456-7890):
Cell (123-456-7890):
Email:
Email will be used to communicate Association news and events.

Cessna 170s you currently own
1st Model:   Year: Reg #: S/N:
2nd Model:   Year: Reg #: S/N:
If you own additional 170s please list them in the comment area

Are you interested in providing hospitality for members visiting in your area? Yes No
Are you a CFI willing to give instruction or flight reviews in a 170? (Check all that apply)
Flight Reviews Instruction In student's 170 In Instructor's 170
How did you learn about TIC170A?
Receive the Flypaper newsletter in PDF via quicker Email or standard print via mail?
Email PDF Print via mail
Receive the bi-yearly membership directory in PDF via Email or bound paper copy.
Email PDF Bound paper copy
Dues include a subscription to THE 170 NEWS, a quarterly magazine. Check here if print magazine is NOT wanted. A PDF is always available for download from the Members Only page.
Comments:

ONLY use this section for mailed or faxed applications.
Type:   Number:   Expires:
Name on Acct:   Signature:___________________________

NOTE: If you are a forum user you must contact the webmaster (webmaster@cessna170.org) to have your forum account upgraded to member status. Upgrading your forum account is NOT an automated process. You must request it. Include in your request your forum account name and method of payment to the association. Payments made by Paypal can be processed as soon as a volunteer sees it usually within a day. When other methods of payment are used we will have to wait until HQ receives payment before forum access is upgraded.

 

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