Regular __________   Associate  ____________

Applicant’s Name: _________________________________________________________________  Date: ____________________
                                                        Surname            Given Name                     Name Used

Address:__________________________________________________________________________ Postal Code:_______________
 

Phone # ____________________________________    Date of Birth ___________________________________________________
 

Next of Kin: _______________________________________________________________ Relationship: ______________________
                                                 Name & Address

Internet (Email) address: _______________________________________________
 

Occupation (formerly, if retired) __________________________________  Employer: _____________________________________
 

Former Wing Member?   Wing # _________ Year ________       MAL?  ______     Legion?  Branch Name: _____________________
____________________________________________________________________________________________________________
Interest Survey:  Please take a minute and circle what activities you might be interested in, i.e.:

Friday lunches           Cards       Dances          Day trips          Pool          Golf              Committee help

Other (please specify)         ____________________________________________________________________________________

Former Military Service; Air Cadets; RCMP:

Component: ________________________________ Dates of Service: FROM: __________________TO:______________________

Medals/Decorations: __________________________________________________________________________________________
___________________________________________________________________________________________________________
I certify that the information provided is correct, and I agree to abide by the Constitution, Rules and Bylaws of
427 (London) Wing of the Air Force Association of Canada. Signing this application form provides your consent
allowing 427 (London) Wing to share your contact information ONLY with other Association members and ONLY
for the purposes of conducting Association business.

Applicant’s Signature: ____________________________   Sponsor: _________________________________

Fees $_________________        Cheque/Cash                   Accepted by: ________________________________
NOTE:  Membership fees MUST be included with application.  (Wing year is from  01 July to 30  June)
_________________________________________________________________________________________________      _______
FOR WING USE ONLY:

Approval:  ______________________________________                         Induction/Kit mailed ______________ Snowball _______

_________________________________________________________________________________________________________