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1. Do you own an Aircraft?
If YES, please specify year & type
2. Highest Pilot Certificate


3. Pilot Ratings
Please check all that apply
Instrument

Airplane

Rotorcraft
Glider
Lighter-Than-Air
Powered-Lift
Powered Parachute
Weight-Shift-Control Aircraft


4. Class Ratings
Please check all that apply
Airplane Class Rating
Single-Engine Land
Single-Engine Sea
Multi-Engine Land
Multi-Engine Sea
Rotorcraft Class Ratings
Helicopter
Gyroplane
Lighter-Than-Air Class Ratings
Airship
Balloon
Weight-Shift-Control Class Ratings
Land
Sea
Powered Parachute Class Ratings
Land
Sea
 

5. Aircraft Type Ratings
Large Aircraft, Other Than Lighter-Than-Air
Turbojet-Powered Airplanes
Other (Please Specify):

6. Pilot Endorsements
Complex Gear
High Performance
High Altitude
Tail-wheel
Other (Please Specify):



7. Total Time PIC

Please choose one of the following 1 year 2 year

Renew

1. Do you own an Aircraft?
If YES, please specify year & type
2. Highest Pilot Certificate

3. Pilot Ratings
Please check all that apply
Instrument

Airplane

Rotorcraft
Glider
Lighter-Than-Air
Powered-Lift
Powered Parachute
Weight-Shift-Control Aircraft


4. Class Ratings
Please check all that apply
Airplane Class Rating
Single-Engine Land
Single-Engine Sea
Multi-Engine Land
Multi-Engine Sea
Rotorcraft Class Ratings
Helicopter
Gyroplane
Lighter-Than-Air Class Ratings
Airship
Balloon
Weight-Shift-Control Class Ratings
Land
Sea
Powered Parachute Class Ratings
Land
Sea
 

5. Aircraft Type Ratings
Large Aircraft, Other Than Lighter-Than-Air
Turbojet-Powered Airplanes
Other (Please Specify):

6. Pilot Endorsements
Complex Gear
High Performance
High Altitude
Tail-wheel
Other (Please Specify):


7. Total Time PIC

Please choose one of the following 1 year 2 year

Or print the form and mail with either a check or money order

to: Midwest Flyer Magazine
PO Box 199
Oregon WI 53575-0199

MIDWEST FLYER MAGAZINE – NEW SUBSCRIPTION & RENEWAL ORDER FORM
simply complete and return the form below:

(X) PLEASE CHECK
___NEW SUBSCRIPTION or ___RENEWAL.

(X) PLEASE CHECK
___ $15 for one year.
___ $25 for two years.

Name__________________________________________________________
Address________________________________________________________
City_______________________________ State________ Zip_____________
Email Address ___________________________________________________

Own aircraft? YES____ NO____
If YES, please specify year and type:_________________________________

Highest Pilot Rating________________________

Highest Pilot Certificates
Please check all that apply
___Student Pilot
___Sport Pilot
___Recreational Pilot
___Private Pilot
___Commercial Pilot
___Airline Transport Pilot
___Flight Instructor
___Ground Instructor

Pilot Ratings
Please check all that apply
___Instrument
___Airplane
___Rotorcraft
___Glider
___Lighter-Than-Air
___Powered-Lift
___Powered Parachute
___Weight-Shift-Control Aircraf

Airplane Class Ratings
Please check all that apply
___Single-Engine Land
___Single-Engine Sea
___Multi-Engine Land
___Multi-Engine Sea
Rotorcraft Class Ratings
Please check all that apply
___Helicopter                                  
___Gyroplane
Lighter-Than-Air Class Ratings
Please check all that apply
___Airship
___Balloon
Weight-Shift-Control Aircraft Class Ratings
Please check all that apply
___Land
___Sea
Powered Parachute Class Ratings
Please check all that apply
___Land
___Sea
 

Aircraft Type Ratings
Please check all that apply
___Large Aircraft, Other Than Lighter-Than-Air
___Turbojet-Powered Airplanes
Other (Please Specify): ________________________________________

Pilot Endorsements
Please check all that apply
___Complex Gear
___High Performance
___High Altitude
___Tail-wheel
Other (Please Specify): ________________________________________

Total Time PIC _____________


Flyer Publications Inc.* Midwest Flyer Magazine
PO Box 199, Oregon, WI 53575-0199 * 608-835-7063 * info@midwestflyer.com