New Member Registration Form

Personal Information
*First Name : 
Middle Name : 
*Last Name : 
Display Name : 
Address : 
*Line 1
Line 2
*Postal Code
Company Name : 
Occupation : 
Office Phone : 
Fax : 
*Home Phone : 
Spouse's Name : 
 Other Aviation Organization Memberships
What brings you to the Duke Flyers Association?
 I own a Duke
 I fly a Duke
 I want to fly a Duke
 I am interested in buying a Duke
 Professional Interest (press, sales, pilot, cfi, etc.)
 I am a Duke fan
 General Interest
Duke Information (if you own or fly a Duke)
Duke Tail Number : 
Duke Serial Number : 
Approx Hrs in a Duke : 
Duke Based At : 
Previous Dukes? : 
Other information about yourself or Duke that may be of interest to other Members
Login Information
*Desired Username : 
Email Address : 
Confirm Email Address : 
*Indicates a required field.