MEMBERSHIP FORM

1. SURNAME_______________________________ FIRST NAME: _____________________________

2. RESIDENCE ADDRESS__________________________________________________________________
______________________________________________________________________________________
TEL_____________________________________ MOBILE __________________________________
EMAIL ADDRESS______________________________________________________________________
3. COMPANY: ______________________________ POSITION HELD____________________________
TEL NO__________________________________

4. ORDINARY / ASSOCIATE MEMBER______________________________________________________

PROPOSED BY: ___________________________ SIGNATURE _______________________________

SECONDED BY ___________________________ SIGNATURE _______________________________

5. MAILING ADDRESS ___________________________________________________________________

(if different from no. 2)
______________________________________________________________________________________

6. ANNUAL MEMBERSHIP: Rs 1500/-

7. LOSS OF LICENCE INSURANCE PROCESSING FEE: Rs 200/- (if applicable)

8. LICENCE TYPE / NUMBER / VALIDITY ___________________________________________________

9. DATE OF BIRTH_____________________

____________________________________ ________________________________________
MEMBERSHIP NUMBER SIGNATURE OF THE APPLICANT

PLEASE INVITE ONE MORE PILOT TO FIP.

NAME ______________________________________ TEL / MOBILE NO __________________________
…………………………………………………………………………………………………………
• Fill the above form in capital letters.
• Send A/c Payee cheque for Rs 1,500/- in Favour of “ FEDERATION OF INDIAN PILOTS”
Loss of Licence Processing Fee is Rs 200/- extra, if Loss of Licence Insurance is availed.
• Write your name in capital letters at the back of the cheque.
• Proposing and seconding of a New Member will be done by F.I.P.
• (Ordinary Members )Flying Licence Holder – Has Voting Rights.
• (Associate Member) Any Individual – With No Voting Rights.
• The Address and contact Nos of the F.I.P. is as stated below:

FEDERATION OF INDIAN PILOTS

GROUND FLOOR, OLD TRANSPORT BLDG, AIR INDIA COMPLEX,
OLD AIRPORT, KALINA, SANTACRUZ (EAST), MUMBAI - 400 029.
TEL: 022 - 26157282 / 26157835 FAX: 022 - 26157325. EMAIL: fipindia2009@gmail.com.