TheCoast Guard Aviation Association
 Ancient Order of the Pterodactyl

New Member Information

Complete this form, then proceed to checkout to pay online.

Life Membership - $250
Active Duty Annual Membership $15
Annual Membership $20/yr        
Due 1 July each year

Update of Contact Information - Pterodactyl Members

Name*Required

Spouse

CG Aviator Number
(if known) 		Rank
address and contact information
E-mail (Primary) *
Publish? *
E-mail (Alternate)
Publish *
Street    
Street    
City State Zip
Home Phone Publish ? *
Work Phone Publish? *

Check all Applicable:

CG Active
CG Aviator (Pilot/Co-pilot)

OPTIONAL QUESTIONS
I'm willing to serve on the following committes

CG Retired
Aircrew/Observer
   Yes No
CG Reserves
Flt Surgeon
 History
Former CG
CG Aux Aviator
Sponsors, Donars, Benefactors
CG/DHS Civilian
CG Aviation Supporter
 Museums, Restorations & Artifacts
Exchange Pilot
Service
Unit Support & Agency Liaison
CG Auxiliary
National Annual Conference (Roost)
CG Aviation Supporter
Communications & Media

* Publish: E-mail and Phone numbers will only be published in the Ptero Roster.
Distribution is limited to Ptero members. The list is never published on our web site!

When your information is completed, hit the Submit button.

Your information will be e-mailed to the AOP secretary after payment is completed through Google Checkout. You will receive a confirmation of your registration via e-mail to the address you enter in Google Checkout.

If you do not wish to pay online, print-out the form and mail with payment to:

 THE ANCIENT ORDER OF THE PTERODACTYL
 P.O. BOX 222905
 Chantilly, VA 20153-2905