John Wise Balloon Society
JohnWise.net
Safety Seminar On-Line Registration
Saturday, March 3, 2012
Millersville University -
You may place your registration now for our ONE DAY seminar:
1-- by filling in this form,
2-- submitting it on-line,
3-- and mailing your check including all applicable fees to the address below.
First Name: *
Last Name: *
Street: *
City: * State: * Zip: *
Email Address:
Phone: *
Pilot/Crew Rating: Pilot Certificate Number: *

BFA Member?: BFA Membership Number:

Do you need Wings Credit:


If you are sending Seminar payment to cover your crew/pilots, please list names here:
-2nd attendee
Name(First, Last):
if pilot- Pilot Certificate Number:    
BFA#:
Email Address:
Phone:
Street Address: City: State: Zip:

-3rd attendee
Name(First, Last): BFA#:
Email Address:
Phone: *
Street: City: State: Zip:

-4th attendee
Name(First, Last):
Email Address:
Phone: *
Street: City: State: Zip:
* indicates required entry
A check in the amount of $* will be mailed within two days of today. See rates listed below.
Make checks payable to John Wise Balloon Society or JWBS
and mail to P.O. Box 5023, Lancaster, PA 17606.
For questions, email Mike Gerred ltaflite@aol.com


or
Registration Fee: Includes year 2012 John Wise Society membership dues.

CREW -- $40.00 prepaid or $45.00 after February 25th.
PILOTS-- $65.00 prepaid or $70.00 after February 25th. Commerical, Private or Student License.


return to Seminar page.