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Civil Air Patrol New Membership Information Request Form
 
MR.    MRS.    MS.
First Name:   MI: Last Name:
Address:
 
City:   State:   Zip Code:
Email Address:  
Phone:       Age:
*Parent's Name:    Required: under 18 years of age

How did you hear about CAP:
  Air ShowCAP Exhibit
 CAP MemberFamily Member
 Former CAP MemberFriend
 MagazineOther
 RadioSchool
 Television
Interests
(check all that apply):
  Aerospace EducationAssociate Member
 Cadet MembershipCadet Mentor
 Cadet Sponsor MembershipCommunications Training
 Disaster ReliefFlight Training
 Glider ProgramInstructor, Aerospace Education
 Instructor, CommunicationsInstructor, Computer/Data Processing
 Instructor, Drill and CeremoniesInstructor, Orientation Flight
 Leadership TrainingMilitary Training
 Model Rocketry ProgramOther
 Pilot, GliderPublic Relations / Marketing
 Search and RescueSenior Membership
 Squadron CommanderSurvival Training
 
Demographics
(check all that apply):
  AOPA MemberAir Force Association Member
 Aircraft OwnerArmed Forces Active Duty
 Armed Forces ReserveArmed Forces Retired
 EAA MemberFAA Certificated Flight Instructor (CFI)
 Former CAP MemberNASAR Member
  National Guard Non-Commissioned Officer
 OfficerPilot, FAA
 Pilot, MilitaryPrior Military Service
 Soaring Society of America Member
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