Join KPA Membership Application First Name * Middle Name Last Name * Spouse First Name (if needed) Street Address * Street Address 2 (if needed) City * State (Choose from dropdown) * AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Zip Code (5 digits) * Email (Primary) * Email Address (Secondary) Phone (Home) * Phone (Cell) Home Airport Identifier (DO NOT include "K" prefix) Are you a Pilot? NoStudent PilotSport PilotRecreational PilotPrivate PilotCommercial PilotAir Transport Pilot Are You Instrument rated? Instrument rated Cat/Class SEL MEL SES MES Helicopter Gyroplane Powered Lift Glider Airship Balloon CFI NoCFICFI - Instrument CFI Ratings SEL MEL SES New Option Mechanic License Airframe Powerplant Airframe Inspector Agreement * I understand that to join I must mail my membership dues of $25/year to: KPA Treasurer 9811 S 183rd W Clearwater, KS 67026 Certification * I certify that the information provided is correct to the best of my knowledge, and I am submitting my application for memebership. reCAPTCHA Submit If you are human, leave this field blank.
