Mason-Dixon Discoverys Chapter Application
Use this form to join the chapter. Chapter dues are FREE for the first year.

Current members should use the Renew form to renew and pay dues: https://tinyurl.com/yy2469gf

Since all chapter dues are renewed in January, new members who join by June 30 will receive free membership for the remainder of the year. New members who join after June 30 will receive the remainder of the year as well as the following year free.

The offer does not apply to former members who are reinstated.

Dues ARE NOT automatically renewed. Dues for additional years are $12 per year.

For questions, contact the chapter Treasurer, Grant Newbury, g_newbury@compuserve.com

The email address entered below will be the primary email used for chapter correspondence.
Email address *
Pilot's First Name *
Your answer
Pilot's Last Name *
Your answer
Co-Pilot's First Name
Your answer
Co-Pilot's Last Name (If different than Pilot's Last Name)
Your answer
Co-Pilots email address
Your answer
Home Phone Number (Enter numbers with NO spaces or characters)
Your answer
Pilots Mobile Number (No spaces or characters)
Your answer
Co-Pilots Mobile (No spaces or characters)
Your answer
Street Address *
Your answer
City *
Your answer
State Abbreviation *
Your answer
ZIP Code
Your answer
DOAI Number - Leave blank if not yet assigned
Your answer
Discovery Year
Your answer
Discovery Model
Your answer
Number of years for which you wish to apply *
Today's Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy